title: Malignant rhabdoid tumor of the liver: case report and literature review.
abstract: A case of malignant rhabdoid tumor (MRT) occurring as a primary hepatic neoplasm in a 12-month-old Japanese female infant is presented. The patient had a slight fever for 2 weeks and presented with a palpable mass in her left hypochondrial region. After admission, the hepatic artery was embolized due to intra-abdominal hemorrhage arising from the tumor. The patient received chemotherapy with cisplatin, cyclophosphamide and adriacin. Despite treatment, the patient developed dyspnea, pancytopenia and disseminated intravascular coagulation. Rupture of the tumor resulted in death within 3 weeks. A limited abdominal autopsy revealed that the liver weighed 1240 g and was occupied by multiple hemorrhagic and/or necrotic tumor nodules. Histologically, neoplastic cells had an abundant eosinophilic cytoplasm containing paranuclear inclusions, and vesicular nuclei with a centrally located prominent nucleolus. Ultrastructurally, the cytoplasmic inclusions were composed of whorled filaments measuring 10 nm. Immunohistochemically, almost all of the neoplastic cells were positive for vimentin and cytokeratins (CK) 8 and 18, some were positive for CK 7 and 19, while none were positive for CK 1, 10, 13-17 and 20. The tumor cells did not express desmin, myoglobin, and alpha-fetoprotein. We found 18 cases of MRT of the liver published in English language literature and then, adding the present case, we summarized the 19 cases. Hepatic MRT is an uncommon neoplasm. However, it should be considered in the differential diagnosis of an aggressive liver neoplasm in childhood.
authors.affiliation: Department of Pathology, Kansai Medical University, Osaka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yuri
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Danbara
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Shikata
authors.forename: Sachiko
authors.initials: S
authors.lastname: Fujimoto
authors.forename: Takahide
authors.initials: T
authors.lastname: Nakano
authors.forename: Noriko
authors.initials: N
authors.lastname: Sakaida
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Uemura
authors.forename: Airo
authors.initials: A
authors.lastname: Tsubura
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D006470:Hemorrhage / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D002479:Inclusion Bodies / Q000648:ultrastructure; D007223:Infant; D008113:Liver Neoplasms / Q000737:chemistry / Q000188:drug therapy / Q000473:pathology*; D018335:Rhabdoid Tumor / Q000737:chemistry / Q000188:drug therapy / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin