PMC4749201_01
Congenital rhabdomyosarcoma: large globular mass arising from left flank of abdomen
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F1
Surgery Outpatient Department of North Bengal Medical College and Hospital, India in 2013 with a large 7cm chi 7cm chi 5cm mass involving the left flank and extending towards the posterior aspect of abdomen. Skin over the mass appeared tense and inflamed (Fig. 1).
Congenital rhabdomyosarcoma: abdominal X-ray revealed a homogeneously dense mass (arrows) involving left flank of abdomen (A); MRI confirmed the mass to be arising from parietal abdominal wall constituents (B & C
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F2
Abdominal skiagram revealed a homogeneous mass density involving the part, without a definite ascertainment towards its site of origin (Fig. 2A). Magnetic resonance imaging (MRI) of her abdomen depicted the mass to be related with the skin, subcutaneous tissue and abdominal wall muscles without any evidence of visceral invasion (Fig. 2B & 2C).
Rhabdomyosarcoma: cytologically, mono-nucleated and bi-nucleated characteristic rhabdomyoblasts in dispersed population admixed with undifferentiated small round cells [H&E stain, 400x (A); Leishman stain, 400x (B)]
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F3
Fine needle aspiration cytology (FNAC) from the mass demonstrated the presence of characteristic well-differentiated rhabdomyoblasts, having round-shaped one-to-two eccentric nuclei and abundant dense inclusion-like cytoplasm; admixed with few undifferentiated small round tumor cells (Fig. 3).
Anaplastic rhabdomyosarcoma: histologically, few pleomorphic, bizarre rhabdomyoblasts (arrows) interspersed between classical ERMS morphology [H&E stain, 100x; inset: H&E stain, 400x
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F4
Few excessively large, pleomorphic rhabdomyoblasts with markedly irregular, hyperchromatic and often complexly lobulated nuclei alongside distinctive rhabdomyoblastic cytoplasm, were conspicuous (Fig. 4).