title: Primary pulmonary rhabdomyosarcoma with brain metastases in a child: a case report with medico-legal implications.
abstract: Rhabdomyosarcoma (RMS) is a rare type of soft tissue sarcoma that mainly affects children. RMS in childhood commonly occurs in the head and neck, followed by the genitourinary tract. Primary pulmonary rhabdomyosarcoma (PPR) is extremely rare. We report a 31-month-old girl who had PPR with brain metastasis. The girl with wheezing and cough of 3 weeks and vomiting of 1 day was referred to a county hospital. At 9:00 a.m., a chest X-ray showed an abnormal shadow on a chest radiogram. Four hours later, in the process of computed tomography (CT) scan her condition deteriorated dramatically, while resuscitation efforts were unsuccessful. CT showed a solid mass in the right middle lung lobe. Subsequent autopsy revealed a large tumour located in the right middle lung lobe. Surprisingly, a mass of haematoma appearance was found in the left occipital lobe. Histological and immunohistochemical investigations of the masses established the diagnosis of PPR with brain metastasis. Herniation of brain, caused by the brain metastasis, was ascertained as the cause of death. The morphological and pathological findings are presented; the difficulty to diagnose PPR and the medico-legal implications are discussed.
authors.affiliation: Department of Forensic Science, School of Basic Medical Sciences, Central South University, Changsha 410013, Hunan, China.
authors.forename: Yadong
authors.initials: Y
authors.lastname: Guo
authors.forename: Dan
authors.initials: D
authors.lastname: Xie
authors.forename: Jie
authors.initials: J
authors.lastname: Yan
authors.forename: Jifeng
authors.initials: J
authors.lastname: Cai
authors.forename: Gang
authors.initials: G
authors.lastname: Yin
authors.forename: Lixiang
authors.initials: L
authors.lastname: Wu
mesh_terms: D001932:Brain Neoplasms / Q000473:pathology / Q000556:secondary*; D002675:Child, Preschool; D005260:Female; D049429:Forensic Pathology; D006547:Hernia / Q000209:etiology / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D012208:Rhabdomyosarcoma / Q000473:pathology*; D014057:Tomography, X-Ray Computed
keywords: Brain metastasis; Forensic pathology; Medical disputes; Primary pulmonary rhabdomyosarcoma; Rhabdomyosarcoma