Guo Yadong, Xie Dan, Yan Jie, Cai Jifeng, Yin Gang, Wu Lixiang
Department of Forensic Science, School of Basic Medical Sciences, Central South University, Changsha 410013, Hunan, China.
J Forensic Leg Med. 2013 Aug;20(6):720-3. doi: 10.1016/j.jflm.2013.04.011. Epub 2013 May 28.
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.
横纹肌肉瘤（RMS）是一种罕见的软组织肉瘤，主要影响儿童。儿童期的RMS通常发生在头颈部，其次是泌尿生殖道。原发性肺横纹肌肉瘤（PPR）极为罕见。我们报告一名31个月大的患有PPR并伴有脑转移的女孩。该女孩有3周的喘息和咳嗽症状以及1天的呕吐症状，被转诊至一家县医院。上午9点，胸部X光片显示胸部有异常阴影。4小时后，在计算机断层扫描（CT）过程中，她的病情急剧恶化，复苏 efforts were unsuccessful（此处原文有误，疑为“复苏努力未成功”）。CT显示右肺中叶有一个实性肿块。随后的尸检发现右肺中叶有一个大肿瘤。令人惊讶的是，在左枕叶发现了一个血肿样肿块。对这些肿块进行组织学和免疫组化检查确诊为PPR伴脑转移。脑转移引起的脑疝被确定为死亡原因。本文展示了形态学和病理学发现；讨论了PPR诊断的困难以及法医学意义。
