Bone metastases as the presenting manifestation of rhabdomyosarcoma in childhood
Autor: | M.J. Terrier-Lacombe, Geneviève Contesso, Lauren V. Ackerman, Françoise Flamant, Dominique Couanet, Daniel Vanel, Lorraine G. Shapeero, Jean Lumbroso |
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Rok vydání: | 1993 |
Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Pathology Adolescent Radiography Bone Neoplasms Scintigraphy Metastasis Diagnosis Differential Neuroblastoma Rhabdomyosarcoma medicine Humans Radiology Nuclear Medicine and imaging Bone pain medicine.diagnostic_test business.industry Magnetic resonance imaging medicine.disease Magnetic Resonance Imaging Primary tumor Child Preschool Neoplasms Unknown Primary Female Radiology medicine.symptom business |
Zdroj: | Skeletal Radiology. 22:433-438 |
ISSN: | 1432-2161 0364-2348 |
Popis: | Rarely, rhabdomyosarcoma can present with bone pain and bone lesions on radiographs without evidence of a primary tumor. Of 428 children with biopsy-proven rhabdomyosarcoma, four presented with radiographic evidence of bone metastases, but no primary tumor was found on subsequent evaluation. On radiographs, these metastases, located most commonly in the metaphyses of the extremities and in the spine, displayed a destructive or diffusely permeative pattern without sclerotic margins and mimicked the more common neuroblastoma. One patient also had diaphyseal cortical lytic metastases of the tibia. Radiographs defined metastases of the extremities better than the correlative bone scans. In the spine, on T2-weighted magnetic resonance (MR) images, metastases displayed high signal intensity which contrasted with the low-signal-intensity marrow in these pediatric patients. On histopathologic examination, metastatic rhabdomyosarcoma was composed of small cells of variable size, shape, and growth pattern similar to other round cell tumors. A positive desmin immunohistochemical test helped to establish the diagnosis. The radiologist, pathologist, and clinician should be aware of this unusual presentation of rhabdomyosarcoma so that suitable immunohistochemical tests are performed and appropriate chemotherapy given. |
Databáze: | OpenAIRE |
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