Cranial metastatic alveolar rhabdomyosarcoma mimicking hematological malignancy in an adolescent boy

Abstract

Background Widespread alveolar rhabdomyosarcoma (ARMS) with bone marrow involvement and with an unknown primary tumor, especially presenting with acute tumor lysis syndrome can be easily misdiagnosed as a hematological malignancy. Furthermore, brain metastasis of ARMS is rare seen in children. Case report Herein, we report a 14-year-old boy presenting with acute tumor lysis syndrome due to bone marrow invasion of ARMS, who was diagnosed after abdominal paraaortic lymph node biopsy. Despite radiological and nuclear medicine imaging, the primary tumor site could not be found. He was treated with vincristine, topotecan, and cyclophosphamide for 42 weeks. Six months after the completion of treatment, he suffered from severe headache, blurred vision, right hemiplegia, and severe bone pain. Cranial magnetic resonance imaging showed multiple hemorrhagic infarctions. Brain biopsy showed brain metastasis with PAX3-FKHR fusion transcript. Conclusion The clinicians must be vigilant about solely brain metastasis in ARMS without additional metastasis.

Management challenges of sinonasal alveolar rhabdomyosarcoma in infanthood: case report and literature review

“…The anomalous expression has been postulated to be part of the tumorigenic behavior by affecting growth control, apoptosis, and differentiation. 13 Cases of aRMS masquerading as acute lymphoblastic leukemia and lymphoma had been reported. 13 Our reported case was an eight month old girl with right sided nasal blockage, watery nasal discharge and a polypoid growth in the same nasal cavity.…”

“…13 Cases of aRMS masquerading as acute lymphoblastic leukemia and lymphoma had been reported. 13 Our reported case was an eight month old girl with right sided nasal blockage, watery nasal discharge and a polypoid growth in the same nasal cavity. The diagnosis of allergic rhinosinusitis with nasal polyposis was made initially due to the similar clinical features.…”

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.…”

Vacuolated Blasts in the Bone Marrow of A Child with Rhabdomyosarcoma

“…We could not distinguish the type of RMS in our patient. RMS should be kept in mind in the differential diagnosis of patients, especially if there are clustering blastic cells, multinucleated giant cells with deep blue cytoplasm, and prominent vacuolization [4].…”