Introduction Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma of childhood. Despite advances in multimodality therapy, the failure-free survival of patients diagnosed with metastatic RMS remains low, at 25% (1). RMS tumors are believed to arise from committed mesenchymal or myogenic progenitor cells that accumulate genetic damage and fail to terminally differentiate (2). RMS tumors largely belong to 2 different histologic subgroupings: 63% are of embryonal RMS (ERMS) histology, while nearly 20% are of alveolar RMS (ARMS) histology (2). In addition to the morphologic and ultrastructural differences between these 2 tumor histologies, they display distinct clinical profiles. ARMS tumors are more likely to be found in the extremities of older children, while ERMS tumors are more commonly found in the head and neck, trunk, and genitourinary systems of younger children (2). ARMS tumors are further associated with a poorer clinical course, exemplified by a higher incidence of bone marrow and lung metastases and higher mortality rate (2).The molecular differences between ARMS and ERMS tumors have been intensively studied (2). Of ARMS tumors, 70% display chromosomal translocations, fusing the neuromuscular development-associated genes paired box 3 (PAX3) and PAX7 to the PKB/