Malignant Rhabdoid Tumor with Cervical Vertebra Involvement in a Teenage Child: Case Report and Review of the Literature

Abstract

Malignant rhabdoid tumor (MRT) is a highly malignant and aggressive tumor associated with the kidney that is mainly seen in children under 5 years old, resulting in a rapid fatal outcome. MRT invasion of the cervical vertebra is an extremely rare form of this malignancy. This study presents a case of MRT involving the C4 vertebra and its appendix. A 13-year-old girl was found to have vague neck pain and a mass in the left neck area of the mid-cervical spine. Percutaneous needle biopsy was performed and the histological and immunohistochemical analysis pointed towards a rhabdoid tumor. Chemotherapy and radiotherapy were performed, but the tumor mass progressively enlarged. Tumorectomy was conducted followed by another 6 courses of chemotherapy and ¹²⁵I radioactive seed implantation. Unfortunately, the C4 vertebra and its appendix were found to be abnormal 3 months after the end of therapy. The patient received an additional tumorectomy, internal fixation with C4 reconstruction by a combined anterior and posterior approach, and 6 courses of consolidation chemotherapy. She is still alive 40 months since the initial diagnosis and remains asymptomatic 31 months after the surgery.

Extra-renal rhabdoid tumor in an adult presenting as cervical adenopathy with spondylodiscitis

“…ERRT have been described in different sites of the human body (liver, skin, and other soft tissues) but are more commonly observed in the central nervous system [ 4 ].…”

“…Considering that MRT may have different cellular origins (epithelial, histiocytic, neuroectodermal, neural, and myogenic) such that different cell types may develop into MRT [ 4 ]. In addition to the fact that it can occur in almost any anatomic location, and that head and neck, and para vertebral muscles are a common location of extra cranial ERRT [ 4 ].…”

“…Considering that MRT may have different cellular origins (epithelial, histiocytic, neuroectodermal, neural, and myogenic) such that different cell types may develop into MRT [ 4 ]. In addition to the fact that it can occur in almost any anatomic location, and that head and neck, and para vertebral muscles are a common location of extra cranial ERRT [ 4 ]. We are not sure if the tumor in this case originates from the vertebra extending to the surrounding soft tissue or it originates from the soft tissue of the neck and invades the vertebra.…”

“…In his case report, Yu Tang et al described a MRT of C4 vertebra treated successfully with neoadjuvant chemotherapy, radiation therapy, twice tumorectomy and radioactive seed implantation with good results until 31 months post-surgery. The authors believe that the use of neo adjuvant chemotherapy and radiation before surgery stopped tumor growth and allowed complete surgical excision which is the most meaningful treatment [ 4 ]. We could only find one case report of MRT with lymph node metastasis to the neck.…”