Neonatal alveolar rhabdomyosarcoma with skin and brain metastases

Authors

  • Carlos Rodriguez-Galindo M.D.,

    1. Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
    2. Department of Pediatrics, University of Tennessee College of Medicine, Memphis, Tennessee
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    • Fax: (901) 521-9005

  • D. Ashley Hill M.D.,

    1. Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
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  • Onynye Onyekwere M.D.,

    1. Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
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  • Noel Pin M.S.,

    1. Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
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  • Bhaskar N. Rao M.D.,

    1. Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee
    2. Department of Surgery, University of Tennessee College of Medicine, Memphis, Tennessee
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  • Fredric A. Hoffer M.D.,

    1. Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee
    2. Department of Radiology, University of Tennessee College of Medicine, Memphis, Tennessee
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  • Larry E. Kun M.D.,

    1. Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
    2. Department of Radiation Oncology, University of Tennessee College of Medicine, Memphis, Tennessee
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  • Alberto S. Pappo M.D.,

    1. Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
    2. Department of Pediatrics, University of Tennessee College of Medicine, Memphis, Tennessee
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  • Victor M. Santana M.D.

    1. Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
    2. Department of Pediatrics, University of Tennessee College of Medicine, Memphis, Tennessee
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Abstract

BACKGROUND

Approximately 5–10% of patients with rhabdomyosarcomas (RMS) are diagnosed during the first year of life, and their clinical characteristics have been well documented. However, because RMS rarely occurs during the neonatal period, little is known about neonatal RMS.

METHODS

Four patients with neonatal RMS were treated at St. Jude Children's Research Hospital between 1962 and 1999. The authors report the results of a review of these patients and of cases described in the literature. Clinical, radiologic, and pathologic features of these patients and their outcomes were evaluated.

RESULTS

One patient with embryonal RMS was treated successfully with a combination of systemic chemotherapy and local control measures. The other three patients had alveolar RMS. Two of them had multiple skin and subcutaneous metastatic nodules at the time of diagnosis and developed brain metastases early in their course. In one of these patients, the PAX3-FKHR fusion transcript was detected. Three other similar cases of neonatal alveolar RMS with metastases to the skin and brain have been reported in the literature.

CONCLUSIONS

A distinct syndrome of neonatal RMS is described. This syndrome is characterized by alveolar histology, multiple skin and subcutaneous metastases, and fatal outcome as the result of early brain metastasis. Cancer 2001;92:1613–20. © 2001 American Cancer Society.

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