Bone Marrow Metastasis of Rhabdomyosarcoma Mimicking Acute Leukemia: A Case Report and Review of the Literature

Abstract

Bone marrow metastasis of rhabdomyosarcoma has been reported to be difficult to distinguish from acute leukemia. We herein describe a case of rhabdomyosarcoma with bone marrow metastasis mimicking acute lymphoblastic leukemia. A 29-year-old woman was admitted with thrombocytopenia, blast-like cells in the peripheral blood and a coagulation disorder. Bone marrow aspirates showed 94.8% blast-like cell infiltration (CD45 -, myeloperoxidase -, and CD56 + ), and CT scan revealed the presence of an infiltrating mass in the nasal cavity. Based on a biopsy of the nasal cavity, the patient was diagnosed with rhabdomyosarcoma exhibiting bone marrow metastasis. She received chemotherapy, followed by radiation therapy, and has since remained alive for 26 months, as of the last follow-up.

Rhabdomyosarcoma debut masquerading as acute lymphoblastic leukemia: A case report and review of the literature

“…Bone marrow infiltration by ARMS is uncommon; some cases can mimic acute leukemia at presentation and thus mislead the diagnosis. We conducted a PubMed search of similar cases of ARMS with a leukemic presentation, finding 41 cases of mimicry reported in the literature, the oldest reported four decades ago . We added our case and reviewed the data available from these reports on Table .…”

“…We conducted a PubMed search of similar cases of ARMS with a leukemic presentation, finding 41 cases of mimicry reported in the literature, the oldest reported four decades ago. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] We added our case and reviewed the data available from these reports on Table 1.…”

Alveolar rhabdomyosarcoma with bone marrow metastasis causes disseminated intravascular coagulation

“…DIC is a rare occurrence in pediatric solid tumors. A review of the literature reveals that DIC appears to be associated with advanced ARMS with BM metastases …”

“…BM aspirate may show infiltration of small blue round cells similar to lymphoblasts or myeloblasts. The condition can be misdiagnosed as acute leukemia . The flow cytometry immunophenotype can help with diagnosis.…”

Acute lymphoblastic leukemia arising after treatment of Ewing sarcoma was misdiagnosed as bone marrow metastasis of Ewing sarcoma

“…Some rare malignant tumors present clinical characteristics and bone marrow aspirate or biopsy morphology similar to that of acute leukemia. Ewing sarcoma (ES), [ 1 , 2 ] medulloblastoma, [ 3 ] neuroblastoma, [ 4 ] anaplastic oligodendroglioma, [ 5 ] rhabdomyosarcoma, [ 6 ] and neuroendocrine tumors have been reported to exhibit acute leukemia-like morphology in bone marrow aspirate samples after metastasizing to the bone marrow. Among these tumors, ES is the second most common primary malignant tumor of the bone, which mainly affects young patients of 5 to 20 years of age.…”