title: Rhabdomyomatous differentiation in Wilms tumor pulmonary metastases: a case report and literature review.
abstract: While sparsely reported in the literature, Wilms tumor may differentiate into more mature mesenchymal tissue types, such as skeletal muscle, following chemotherapy. The frequency of this event is unknown. Chemotherapy and radiation may induce cytodifferentiation of Wilms tumor cells or select for the survival of less mitotically active cells. In follow-up biopsies, the presence of rhabdomyomatous differentiation can confound the histologic diagnosis. Furthermore, these differentiated tumors appear to be more resistant to chemotherapy, thus biopsy and positron emission tomography scans following chemotherapy and radiation may prevent unnecessary treatment. We report an unusual case of Wilms tumor in a 21- year-old man with rhabdomyomatous differentiation of pulmonary metastases after chemotherapy, which presented a challenge during frozen section diagnosis.
authors.affiliation: University of South Florida College of Medicine, Tampa, FL, USA.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Seifert
authors.forename: Patricia
authors.initials: P
authors.lastname: McNab
authors.forename: Wade J
authors.initials: WJ
authors.lastname: Sexton
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Sawczyn
authors.forename: Prudence
authors.initials: P
authors.lastname: Smith
authors.forename: Domenico
authors.initials: D
authors.lastname: Coppola
authors.forename: Marilyn M
authors.initials: MM
authors.lastname: Bui
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D002454:Cell Differentiation / Q000187:drug effects / Q000502:physiology* / Q000528:radiation effects; D059248:Chemoradiotherapy / Q000009:adverse effects*; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary*; D008279:Magnetic Resonance Imaging; D008297:Male; D012207:Rhabdomyoma / Q000209:etiology / Q000473:pathology*; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor