Cytologic features of adult spindle cell variant of rhabdomyosarcoma: A report of two cases

✍ Scribed by Ajay Patel; Jeremiah B. Placido; Lisa Pitelka; Paolo Gattuso; Michael Liptay; Anthony Kim

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 443 KB
• Volume: 37
• Category: Article
• ISSN: 8755-1039
• DOI: 10.1002/dc.21189

✦ Synopsis

Spindle cell rhabdomyosarcoma is a rare variant of embryonal rhabdomyosarcoma that was first described in 1992 in the pediatric population by the German-Italian Cooperative Sarcoma study. 1 In children and young adults, it occurs predominately in the paratesticular region and has a good prognosis when compared with the other classic forms of rhabdomyosarcoma. In 1998, Rubin et al. reported the first examples of spindle cell rhabdomyosarcoma in adults. 2 These tumors show a more aggressive clinical course with the two patients dying of the disease shortly after diagnosis. The largest review to date of this entity was performed by Nascimento and Fletcher who over an 18-year period, found 16 cases of adult spindle cell rhabdomyosarcoma (age 18-years and older) which showed a male predominance (2.2:1), median age of 32 years, and a predilection for the head and neck area. The remaining cases occurred in the retroperitoneum, thigh, leg, subscapular area, hand, vulva, and paratesticular region. Sixty-four percent of these patients had either localized tumor or metastases post-therapy and 17% died soon after diagnosis. 3 The cytologic features of spindle cell rhabdomyosarcoma are sparse in the literature with only one previously published case report in the literature to date in a 13year-old child with paratesticular disease. 4 This brief communication describes the cytologic features on crush preparations of two additional cases of spindle cell rhabdomyosarcoma occurring in two adult patients.

The first patient, a 27-year-old male, presented to the orthopedic oncologist with a painful disabling left calf