title: Alveolar Rhabdomyosarcoma of the foot metastasizing to the Iris: report of a rare case.
abstract: Intraocular iris rhabdomyosarcoma is extremely rare, and in the 3 cases reported to date occurred as the primary site of tumour growth. We report a case of rhabdomyosarcoma of the foot metastasizing to the iris.
  
  
  
  An 18-year-old white female was referred to the London Ocular Oncology Service for management of a metastatic rhabdomyosarcomatous deposit in the iris, a metastasis from alveolar rhabdomyosarcoma of the foot. She was diagnosed nearly 2 years earlier with the primary sarcoma with extensive systemic spread and treated by resection of the foot lesion and chemotherapy, and achieved a partial remission. The left iris deposit was noted while she was receiving systemic chemotherapy, heralding a relapse. However, anterior uveitis and raised intraocular pressure developed and she was referred to our service for further management. A left iris secondary rhabdomyosarcoma deposit was noticed and in addition a lacrimal gland mass, as indicated by ultrasound B scan of the eye and orbit. The patient was treated with external beam radiotherapy to the globe and orbit, but died 2 months after treatment completion.
  
  
  
  Rhabdomyosarcoma of the iris is very rare and was previously documented only as a primary malignancy in this location. We report that secondary spread to the iris can also occur, in this case as the first sign of widely disseminated systemic relapse.
authors.affiliation: Ocular Oncology Service, Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD, UK. didifabian@gmail.com.|St. Bartholomew's Hospital, London, UK. didifabian@gmail.com.
authors.forename: Ido Didi
authors.initials: ID
authors.lastname: Fabian
authors.affiliation: Oxford Eye Hospital, The John Radcliffe Hospital, Oxford University Hospitals, Oxford, UK.
authors.forename: G Darius
authors.initials: GD
authors.lastname: Hildebrand
authors.affiliation: Paediatric Haematology/Oncology Department, John Radcliffe Hospital, Oxford University Hospitals, Oxford, UK.
authors.forename: Shaun
authors.initials: S
authors.lastname: Wilson
authors.affiliation: Churchill Hospital, Oxford University Hospitals, Oxford, UK.
authors.forename: Tina
authors.initials: T
authors.lastname: Foord
authors.affiliation: Ocular Oncology Service, Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD, UK.|St. Bartholomew's Hospital, London, UK.|UCL Institute of Ophthalmology, London, UK.
authors.forename: Mandeep S
authors.initials: MS
authors.lastname: Sagoo
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D017809:Fatal Outcome; D005260:Female; D005534:Foot Diseases / Q000150:complications* / Q000473:pathology*; D006801:Humans; D015811:Iris Neoplasms / Q000175:diagnosis / Q000532:radiotherapy / Q000556:secondary*; D035583:Rare Diseases / Q000209:etiology*; D018232:Rhabdomyosarcoma, Alveolar / Q000556:secondary* / Q000628:therapy; D014463:Ultrasonography; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
keywords: Case report; Iris; Metastasis; Rhabdomyosarcoma