A 5-year-old boy presented with progressive left-sided weakness and mental obtundation. Two-and-a-half years before this admission, he had surgery elsewhere for a presumed primitive neuroectodermal tumor followed by radiotherapy and chemotherapy. At presentation, he was drowsy and was responsive to repeated calls. He had a dilated, unreactive right pupil and left hemiparesis. A contrast-enhanced computed tomography (CT) scan showed a large isodense enhancing mass in the right fronto-temporo-parietal lobe with severe edema and uncal herniation [Figure 1]. Preoperative blood counts, biochemical investigations, and a coagulation profile were normal and he was taken up for emergency surgery. Total excision of the large, well-delineated, vascular, lobulated mass of variegated consistency was done. Intraoperatively just after the debulking was commenced, he developed hematuria.
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