Rhabdomyosarcoma of the thigh metastatic to the breast of a 12-year old girl - A case report

Introduction Rhabdomyosarcoma (RMS) is a common entity, accounting for 61% of all soft-tissue sarcomas in children. However, metastases or primary RMS of the breast have been reported in only 3% to 6% of RMS cases. Head and neck region (40%), the genitourinary system (22%) and the extremities (18%) are the most common primary sites. The respective symptoms are directly dependent on the localization of the tumor and are thus highly variable.After histopathological analysis MRI, ultrasound, bone scan and PET-CT/PET-MRI are necessary to determine the extent of local invasion and any metastasis. Treatment options are chemotherapy, surgery and radiation depending on size of tumor, invasion, histology, resectability and age.

Casereport Presentation of 12-year-old female patient with palpable, painful tumor of the left thigh and a secondary tumor of the right thoracic wall. X-ray, MRI, PET-CT and ultrasound examinations were performed. Biopsies of both findings histologically revealed an alveolar rhabdomyosarcoma. During chemotherapy, both findings presented as markedly reduced. The patient presented with sepsis during aplastic anemia, prerenal kidney failure, mucositis, and severe vomiting. Chemotherapy could be continued under antibiotic and supportive therapy.

Discussion Alveolar origin, age over 10 years, tumor size over 5cm and metastasis are considered prognostically unfavorable parameters and are associated with poor outcome despite intensified chemotherapy. Little is known regarding tumor development.

Conclusion We present a very rare case of breast involvement in RMS. There is an urgent need for the development of new therapeutic approaches for metastatic RMS such as targeted immunotherapy to improve patient outcome.

Publication History

Article published online:
01 June 2021