title: Metastatic germ cell tumor of the lung masquerading as primary rhabdomyosarcoma.
abstract: Two years after testicular resection was carried out in a 40-year-old man that revealed mixed germ cell tumor of more than one histological type (seminoma, embryonal cell carcinoma, and yolk sac tumor), he presented with an asymptomatic pulmonary nodule in his left lower lobe. Video-assisted thoracoscopic partial resection of the tumor revealed a 24 x 20 mm teratoma with somatic-type malignancy in which pleomorphic rhabdomyosarcoma was a major element. One year later, asymptomatic tumor recurrence occurred at both edges of the stapler line as 22 x 20 mm and 10 x 5 mm nodules composed only of pleomorphic rhabdomyosarcoma. Throughout the course there was no abdominal lymph node swelling detected by computed tomography (CT) and tumor markers were normal. Adjuvant chemotherapy was started after the tumor recurrence. Currently, the patient is still undergoing chemotherapy 5 months after the tumor recurrence. In conclusion, despite the fact that primary pulmonary rhabdromyosarcoma is a rare neoplasm, metastatic pulmonary germ cell tumor with somatic-type malignancy showing predominantly rhabdomyosarcomatous differentiation should be considered in the differential diagnosis of such lesions of the lung.
authors.affiliation: Department of Basic Pathology, Chiba University Graduate School of Medicine, Japan. randasobhy2000@yahoo.com
authors.forename: Randa Mahmoud Sobhy
authors.initials: RM
authors.lastname: Amin
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kokubo
authors.forename: Kenzo
authors.initials: K
authors.lastname: Hiroshima
authors.forename: Makoto
authors.initials: M
authors.lastname: Narita
authors.forename: Kensuke
authors.initials: K
authors.lastname: Itou
authors.forename: Motoo
authors.initials: M
authors.lastname: Kuroki
authors.forename: Tohru
authors.initials: T
authors.lastname: Tanizawa
authors.forename: Yukio
authors.initials: Y
authors.lastname: Nakatani
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D006801:Humans; D007124:Immunoenzyme Techniques; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D008297:Male; D009364:Neoplasm Recurrence, Local; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D012208:Rhabdomyosarcoma / Q000175:diagnosis*; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor