Cranial metastatic alveolar rhabdomyosarcoma mimicking hematological malignancy in an adolescent boy

Spontaneous tumor lysis syndrome in an adult with alveolar rhabdomyosarcoma: a challenging diagnosis

Tumor lysis syndrome (TLS) is an oncological emergency characterized by metabolic and electrolyte imbalances associated with the rapid destruction of tumor cells. It is commonly recognized when cytotoxic treatment for hematological malignancies is initiated. Spontaneous TLS with solid tumors like rhabdomyosarcoma (RMS) is exceedingly rare. It has been noted that the highest incidence of this tumor occurs in individuals under the age of 20 years, with an incidence rate of 4.4 cases per 1 million. Here, we present the case of a 22-year-old male who presented with spontaneous clinical TLS. A computed tomography (CT) scan revealed a large pelvic mass, diffuse lymphadenopathy, and infiltration of the ocular muscles. Subsequently, a biopsy was conducted, and the histopathological results indicated alveolar rhabdomyosarcoma. Our literature review revealed five cases of spontaneous TLS caused by RMS, with our patient being the only adult among all published cases.

Alveolar rhabdomyosarcoma metastatic to the brain

Alveolar rhabdomyosarcoma (ARMS) has a predilection for the peripheral extremities, and brain metastases are rare, with only a few cases reported after the initial diagnosis. We present a 22-year-old male patient with a right orbital-ethmoidal ARMS who presented with a recurrence to the brain 1 year after the initial diagnosis. He was referred to our institution due to acute neurological deterioration. A brain MRI was performed, showing an enhancing bilateral parafalcine lesion centred about the bilateral cingulate gyri with extension into the corpus callosum. The patient was taken to the operating room for a stereotactic biopsy under general anaesthesia, which was compatible with metastatic ARMS. Our case is exceedingly rare, considering the initial diagnosis of an orbital/ethmoidal ARMS, its subsequent metastasis to the brain and its clinical sequelae after a biopsy. Prognosis after cerebral metastatic ARMS is dismal, with most patients expiring due to central nervous system metastatic disease.

Rhabdomyosarcoma debut masquerading as acute lymphoblastic leukemia: A case report and review of the literature

Bone marrow infiltration by alveolar rhabdomyosarcoma is uncommon, some cases can mimicry acute leukemia at presentation and mislead the diagnosis. The integration of diagnostics tests and techniques in uncommon malignancies is important to suspect and reach the diagnosis and avoid delay on treatment. We report a case of alveolar rhabdomyosarcoma bone marrow infiltration associated with hemophagocytosis and cell cannibalism, mimicking acute leukemia at presentation.