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Annals of Oncology 13:323-326, 2002
© 2002 European Society for Medical Oncology

Rhabdomyosarcoma arising in mediastinal teratoma in an adult man: a case report

N. Omezzine1, C. Khouatra1, S. Larivé1, G. Freyer2, S. Isaac-Pinet3, L. Gérinière1, J.-P. Droz4 and P.-J. Souquet1,+

1Department of Pneumology; 2Unit of Medical Oncology; 3Unity of Pathological Anatomy, Centre Hospitalier Lyon-Sud, Pierre-Benite Cedex and 4Centre Leon Berard, Lyon, France

Received 12 February 2001; revised 18 April 2001; accepted 3 May 2001.

We report a case of rhabdomyosarcoma which occurred in a mediastinal teratoma in a 44-year-old man. Presentation symptoms were chest pain, hoarseness and a cough. Diagnosis was fortuitous, performed by the histological and immunohistochemical study of a mediastinal tumour biopsy specimen that showed embryonal carcinoma and yolk sac tumour components associated with the rhabdomyosarcoma. After cisplatin-based chemotherapy (bleomycin–etoposide–cisplatin), surgical resection of the residual mediastinal tumour was performed. Histological and immunohistochemical study of this tumour confirmed the presence of mature teratoma and embryonal rhabdomyosarcoma. Evolution was marked by a local extension of the mediastinal tumour, occurrence of multiple metastases and bone marrow involvement. The patient died 8 months after diagnosis despite chemotherapy and radiotherapy. A review of the literature reveals that the development of rhabdomyosarcoma in primary mediastinal teratomas is unusual in adults. The diagnostic, therapeutic and prognostic implications of such an association are reviewed.

Key words: embryonal rhabdomyosarcoma, mediastinal germ-cell tumour, teratoma, yolk sac tumour


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