RESUMO
Sclerosing rhabdomyosarcoma (RMS) is a rare subtype of RMS with unique prominent stromal hyalinization and a pseudovascular architecture. It overlaps morphologically with spindle cell RMS and poses both diagnostic and therapeutic challenges because of its rarity and aggressive clinical course. In this article, we report a case of sclerosing RMS arising from a prior craniotomy site, which demonstrated both sclerosing and spindle cell components. A literature review of RMS with sclerosing morphology identified 122 cases. Our review documents the following: sclerosing RMS occurs in both childhood and adult populations, has a predilection for the head and neck areas, and has a worse prognosis in adults. Sclerosing RMS harbors a high frequency of MYOD1 mutations, conferring a poor clinical outcome. Sclerosing RMS and spindle RMS likely represent a morphologic spectrum of one entity.
Assuntos
Craniotomia/efeitos adversos , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias Musculares/patologia , Rabdomiossarcoma/patologia , Tela Subcutânea/patologia , Aneurisma Roto/etiologia , Aneurisma Roto/cirurgia , Biópsia , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Quimiorradioterapia Adjuvante , Diagnóstico Diferencial , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/etiologia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Aneurisma Intracraniano/complicações , Masculino , Pessoa de Meia-Idade , Neoplasias Musculares/diagnóstico por imagem , Neoplasias Musculares/etiologia , Neoplasias Musculares/terapia , Rabdomiossarcoma/diagnóstico por imagem , Rabdomiossarcoma/etiologia , Rabdomiossarcoma/terapia , Couro Cabeludo , Esclerose , Tela Subcutânea/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
We report the case of a 62-year-old woman who underwent laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection for endometrial endometrioid carcinoma FIGO grade 1. Cytologic examination of the pelvic washing specimen showed an acellular matrix with frayed edges and cracking artifact. Upon investigation, it became apparent that this could represent hemostatic matrix FlosealR that had been used intraoperatively at the lymphadenectomy site. Laboratory replication of the cytologic findings with a FlosealR sample confirmed it. This is the first reported case of FlosealR in pelvic washing cytology and represents a potential diagnostic pitfall. Diagn. Cytopathol. 2016;44:1117-1119. © 2016 Wiley Periodicals, Inc.