title: Primary rhabdomyosarcoma of the distal femoral diaphysis: a case report and review of the literature.
abstract: Primary rhabdomyosarcoma of the bone is an extremely rare condition with few examples reported in the literature. We present the case of a 34-year-old male who presented with a lesion in the distal femur with initial imaging features consistent with Ewing sarcoma. Histologically, the lesion consisted of atypical pleomorphic polygonal rhabdomyoblasts demonstrating focal desmin and myogenin expression. A diagnosis of pleomorphic rhabdomyosarcoma was rendered. Despite systemic treatment and surgery, this patient experienced a rapidly progressive disease course. We believe this is only the second report in the orthopedic literature of a case of primary pleomorphic rhabdomyosarcoma of the bone. The key imaging, pathologic, and clinical findings are discussed.
authors.affiliation: The Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD, 21205, USA.
authors.forename: Jarred A
authors.initials: JA
authors.lastname: Bressner
authors.affiliation: Department of Pathology, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD, 21287, USA.
authors.forename: Edward F
authors.initials: EF
authors.lastname: McCarthy
authors.affiliation: Musculoskeletal Radiology, The Russell H. Morgan Department of Radiology and Radiologic Science, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Fayad
authors.affiliation: Division of Orthopaedic Oncology, Department of Orthopaedic Surgery, The Johns Hopkins Hospital, 601 North Caroline Street, Baltimore, MD, 21287, USA. cmorri61@jhmi.edu.
authors.forename: Carol D
authors.initials: CD
authors.lastname: Morris
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D018483:Diaphyses / Q000000981:diagnostic imaging / Q000473:pathology; D005266:Femoral Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008297:Male; D035583:Rare Diseases / Q000000981:diagnostic imaging* / Q000473:pathology*; D012208:Rhabdomyosarcoma / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D012512:Sarcoma, Ewing / Q000175:diagnosis / Q000473:pathology
keywords: Adult rhabdomyosarcoma; Pleomorphic rhabdomyosarcoma; Primary rhabdomyosarcoma of bone