Clear cell sarcoma of the kidney metastatic to jaw: case report.

A case of an 8 year-old boy with history of nephroblastoma (Wilms' tumor) three years prior, which was managed with nephrectomy, chemotherapy and radiotherapy, is presented. During a routine follow up, a three month old rapidly growing mass on the left side of the face was detected. The roentgenogram showed a lytic lesion in the body and ascending ramus of the left jaw. Re-evaluation of the previous renal tumor was interpreted as a clear cell sarcoma of the kidney. Biopsy of the lesion of the left jaw showed similar histology, therefore, the diagnosis of clear cell sarcoma of the kidney metastatic to the left jaw was rendered. This is a rare case and to our knowledge is the first in the world's literature. We emphasize the diagnostic challenge of both the primary neoplasm and the metastasis and discuss the differential diagnosis of primary and metastatic sarcomas.

Rhabdomyosarcoma in children: report of two cases.

Rhabdomyosarcoma of soft tissue is the commonest sarcoma in pediatric medicine and comprises 15% of the solid tumors treated in pediatric oncology. It has an ample variety of clinical presentations in diverse organs and also presents a gamut of histopathological patterns, which sometimes make diagnosis difficult. We report two cases of rhabdomyosarcoma: one of the embryonic histological variety and the second one of the alveolar variety, which presented themselves in the preauricular and masseteric areas respectively. Both patients were male, diagnosed and treated.

Sudden death due to undetected mediastinal germ cell tumor.

A 32-year old man, apparently asymptomatic, was found dead in his apartment. Autopsy revealed a large necrotic mediastinal mass with liver and occipital brain metastases, the latter having produced acute intraparenchymal and intraventricular hemorrhage with cerebellar tonsillar herniation. Histologically, the mediastinal mass and metastases were consistent with immature extragonadal teratoma, with malignant transformation of the intestinal-type epithelium. Undiagnosed neoplasms as causes of sudden death are quite rare and usually reported in older age groups; however, in one study of autopsies in a 25-to 46-year-old age group, a significant 3.2% was reported. Germ cell tumors of the mediastinum are the most common extragonadal primary site, accounting for approximately 50%-70% of extragonadal germ cell tumors (EGCTs) and primarily affecting 20- to 35-year-old men. EGCTs are usually symptomatic at the time of diagnosis, although a large proportion may be asymptomatic. This case represents one the few reported cases of sudden death as a result of mediastinal EGCT; it also demonstrates the natural course of this disease and underscores the importance of medicolegal autopsies in cases of sudden death.