PMC9478914_01
Histological and immunohistochemical findings. (A) Immunohistochemical staining for desmin shows positivity (x100), which indicates sarcoma. (B) HE staining (x100) of embryonic rhabdomyosarcoma. (C) Immunohistochemical staining for MyoD1 shows negativity (x100). (D) Immunohistochemical staining for myogenin shows negativity (x100).
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The immunohistochemical results suggested embryonic rhabdomyosarcoma ( Figures 1A-D ).
The changes in complete blood count (RBC, WBC, lymphocyte, and granulocyte) depended on the date (October 28, 2021-January 18, 2022).
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The changes in whole blood-cell count during radiotherapy are shown in  Figure 2 .
Chest CT before (A) and after (B) 60Gy/30 fractions of radiotherapy combined with chemotherapy, the tumor shrank significantly on the radiograph.
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After 60 Gy of radiotherapy administered in 30 fractions, the tumor was significantly shrunken on CT scan ( Figure 3 ), and the patient's symptoms of dysphagia were alleviated.
(A1, B1) Chest CT taken on October 29, 2021, before concurrent radiotherapy and chemotherapy. No obvious lung metastasis was found. (A, B) Chest CT taken on January 18, 2022, showing scattered nodules of different sizes in both lungs. The largest nodule was located near the heart border in the middle lobe of the right lung, which indicated pulmonary metastasis.
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The patient's reexamination on January 18, 2022, indicated pulmonary metastases ( Figures 4A, B ).