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Rhabdomyosarcoma presenting with diffuse bone marrow involvement, hypercalcemia and renal failure.

F Javier de la Serna¹, M A Martinez, M D Valdes

¹Department of Hematology, Hospital, 1 de Octubre, Madrid, Spain.

Medical and Pediatric Oncology

|January 1, 1988

Summary

This case report highlights diffuse bone marrow involvement as the sole presentation of rhabdomyosarcoma in an adolescent. Early diagnosis and chemotherapy are crucial for managing this rare pediatric cancer manifestation.

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Area of Science:

Pediatric Oncology
Hematology
Pathology

Background:

Rhabdomyosarcoma and small round-cell neoplasms commonly metastasize to bone marrow in children.
Diffuse bone marrow involvement as the sole presentation poses a significant diagnostic challenge.

Observation:

An 18-year-old male presented with back pain, sternum tenderness, anemia, thrombocytopenia, leukoerythroblastic blood, hypercalcemia, and renal failure.
No primary solid tumor was identified.
Morphological and ultrastructural findings confirmed rhabdomyoblastic bone marrow metastatic involvement.

Findings:

The patient's hypercalcemia and renal failure were managed with furosemide and calcitonin.
Intensive chemotherapy (vincristine, actinomycin D, cyclophosphamide, doxorubicin) was administered.

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Initial remission was achieved but lasted only 5 months before relapse occurred.

Implications:

This case underscores the importance of considering rhabdomyosarcoma in adolescents with unexplained bone marrow failure and hypercalcemia.
Prompt diagnosis and multimodal treatment are essential for improving outcomes in such rare presentations.
The challenges in achieving durable remission highlight the need for further research into novel therapeutic strategies.