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[A case of brain metastasis of rhabdomyosarcoma in a child]
S Tamatani1, K Tanimura, M Kawamata
1Department of Neurosurgery, Sannocho Hospital, Niigata, Japan.
Insights
This case study details a rare brain metastasis from rhabdomyosarcoma in an 11-year-old boy. Despite rapid tumor growth, the intracranial region showed minimal changes, a unique observation in metastatic brain tumors.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Skeletal Muscle Tumors
Background:
- Rhabdomyosarcoma is a rare pediatric malignancy.
- Metastasis to the brain is uncommon but can occur.
Observation:
- An 11-year-old boy presented with headache, exophthalmos, and bilateral cranial tumors.
- Previous diagnosis of rhabdomyosarcoma in the right foot with subtotal removal.
- Imaging revealed extraaxial masses with significant contrast enhancement.
Findings:
- Histological analysis confirmed rhabdomyosarcoma metastasis involving skull bone, dura, and subdural tissues.
- Tumors rapidly increased in size but caused minimal intracranial changes.
- Meningeal artery supplied numerous tumor vessels.
Implications:
- Highlights the aggressive nature of rhabdomyosarcoma, even with unusual intracranial presentation.
- Suggests potential for varied radiological findings in pediatric brain metastases.
- Underscores the importance of thorough investigation for metastatic disease in pediatric oncology.
Abstract:
We report here a specific case of metastatic brain tumor orienting from rhabdomyosarcoma. An 11-year-old boy came to our hospital with complaints including headache, exophthalmos and tumors in the right frontal and left occipital region. 6 months previously subtotal removal of rhabdomyosarcoma in his right foot had been performed. CT scan demonstrated tumors in the right orbit, right frontal region and left occipital region. The tumors existed bilaterally in the skull and markedly enhanced by contrast medium. But the changes of the cranium were mild, only the dipole was slightly dilated. MRI showed that the tumors were extraaxial masses. Right external carotid angiogram revealed numerous tumor vessels fed by the meningeal artery. On April 3rd, biopsy was performed at the right frontal region. The tumor had spread in the epidural space but the cortical surface seemed to be intact. Histologically, the tumor consisted of small round cells and revealed multinuclear giant cells. It involved the skull bone, dura mater and subdural tissues. Accordingly the tumor was diagnosed as rhabdomyosarcoma. Although tumor increased rapidly, the intracranial region did not change remarkably. It was an interesting phenomenon. Eventually, rhabdomyosarcoma metastasized to the lung, and the patient died due to respiratory distress.
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