SALL4 and C-kit positive malignant extrarenal rhabdoid tumor of the pelvis in a child: A diagnostic and therapeutic challenge.

Saloni Pahwa, Sunil Pasricha, Gauri Kapoor, Ankush Jajodia, Venkata Pradeep Babu Koyyala, Anurag Mehta
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Abstract

Abstract: Extrarenal rhabdoid tumors (ERRTs) are highly aggressive pediatric tumors with very few cases reported in the literature. These tumors, similar to their renal counterparts, are characterized by inactivating mutations of the SMARCB1/INI-1 gene, a member of the SWI/SNF chromatin remodeling pathway. Diagnosis of ERRTs appears challenging owing to its rarity, varied morphological profile with a higher tendency for rhabdoid differentiation, and overlapping features with other SMARCB-1 deficient tumors. Here, we report a case of ERRT in the pelvis of a three-year-old child with an unusual expression of SALL4 and C-kit on immunohistochemistry. A complete immunohistochemical workup might help in differentiating ERRTs from other SMARCB1/INI1-deficient soft tissue tumors. The expression of stem cell markers in the presented case also suggests that these tumors might originate from or share similarities with embryonic stem cells or germ cells.

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一名儿童盆腔恶性肾外横纹肌瘤 SALL4 和 C-kit 阳性:诊断和治疗难题。
摘要:肾外横纹肌瘤(ERRTs)是一种侵袭性极强的儿科肿瘤,文献报道的病例极少。这些肿瘤与肾脏肿瘤类似,其特征是SMARCB1/INI-1基因的失活突变,SMARCB1/INI-1基因是SWI/SNF染色质重塑途径的成员。ERRTs的诊断具有挑战性,因为它非常罕见,形态特征多样,更倾向于横纹肌样分化,而且与其他SMARCB-1缺陷性肿瘤的特征重叠。在此,我们报告了一例三岁儿童盆腔ERRT,其免疫组化结果显示SALL4和C-kit表达异常。完整的免疫组化检查可能有助于将ERRT与其他SMARCB1/INI1缺陷型软组织肿瘤区分开来。本病例中干细胞标记物的表达也表明,这些肿瘤可能起源于胚胎干细胞或生殖细胞,或与胚胎干细胞或生殖细胞有相似之处。
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