title: Endoscopic ultrasound-guided fine-needle aspiration of metastatic alveolar rhabdomyosarcoma to the pancreas with fluorescence in situ hybridization: a case report.
abstract: Alveolar rhabdomyosarcoma (ARMS) is a rare tumor in adults. Cytologic diagnosis of metastatic ARMS to the pancreas diagnosed by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has been reported rarely in the literature. A 20-year-old male with a history of ARMS in the right maxillary sinus resected one year earlier and pancreatitis treated two months earlier, presented on routine follow-up. Abdominal positron electron tomography-CT scan revealed a mass in the pancreas and fluorodeoxyglucose uptake in the left paraaortic lymph node. Subsequent magnetic resonance imaging of the abdomen showed a 3.6 × 6.4 cm mass in the tail of the pancreas. EUS-FNA was performed using a 22-gauge needle. Cytologic criteria and immunohistochemistry in the smears were analyzed. A diagnosis consistent with metastatic ARMS was rendered. Subsequent FISH analysis of the case and histologic review of the primary tumor supported the final diagnosis. A diagnosis of metastatic ARMS to the pancreas can be made by EUS-FNA. FISH can be used as an ancillary technique in diagnosing the tumor.
authors.affiliation: University of Utah, Salt Lake City, UT, USA. andrea.trujillo@aruplab.com
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Trujillo
authors.forename: Evelyn V
authors.initials: EV
authors.lastname: Gopez
authors.forename: Brian T
authors.initials: BT
authors.lastname: Collins
mesh_terms: D044963:Biopsy, Fine-Needle / Q000379:methods; D048430:Cell Shape; D048429:Cell Size; D002843:Chromatin / Q000235:genetics / Q000378:metabolism; D004724:Endoscopy / Q000379:methods; D000071161:Forkhead Box Protein O1; D051858:Forkhead Transcription Factors / Q000235:genetics; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary*; D018232:Rhabdomyosarcoma, Alveolar / Q000175:diagnosis / Q000235:genetics / Q000556:secondary*; D025321:Surgery, Computer-Assisted / Q000379:methods; D014178:Translocation, Genetic; D055815:Young Adult
chemical_list: D002843:Chromatin; C085126:FOXO1 protein, human; D000071161:Forkhead Box Protein O1; D051858:Forkhead Transcription Factors