J Korean Neurosurg Soc.  2014 Jan;55(1):57-60. 10.3340/jkns.2014.55.1.57.

Malignant Rhabdoid Tumor of the Kidney and Spine in an Infant

• Park S
• Seo JH
• Park JB
• Park S

• KMID: 2191044
• DOI: http://doi.org/10.3340/jkns.2014.55.1.57

Abstract

Rhabdoid tumor of the kidney (RTK) is a rare malignancy in infancy. Central nervous system involvement in RTK is already known. However, solitary spinal metastasis in RTK has been hardly reported. The authors report a case of metastatic RTK to spine causing paraplegia in an 8-month-old girl. Since the patient was young, the diagnosis of spine metastasis was delayed until paraplegia was seen after radical nephrectomy. Thorough neurological examination should be performed for early diagnosis of spinal metastasis in young patients with RTK. If there are any abnormal signs in neurologic examination, magnetic resonance images of brain and spine are recommended.

Keyword

Rhabdoid tumor; Infant; Kidney; Spine

MeSH Terms

Brain
Central Nervous System
Diagnosis
Early Diagnosis
Female
Humans
Infant*
Kidney*
Neoplasm Metastasis
Nephrectomy
Neurologic Examination
Paraplegia
Rhabdoid Tumor*
Spine*

Figure

• 

  Fig. 1 The CT shows a 8×5.8×5.3 cm sized heterogeneous left renal mass without lymph node enlargement.

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  Fig. 2 Histologic and immunostain appearance. Cut section of the kidney reveals a well circumscribed, ovoid, firm mass in the lower pole of the kidney (A). Histology showed the characteristic findings of rhabdoid tumor including a highly cellular neoplasm composed of tumor cells of varying size with prominent nucleoli and abundant cytoplasm (B, hematoxylin-eosin stain, ×400). Immunostains showed negative staining for INI1 (C).

• 

  Fig. 3 The T1-weighted enhancing lumbar MRI shows a 6.5×1 cm sized intradural extramedullary tubular mass with heterogeneous enhancement at L1-S1 level.

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  Fig. 4 A : Intraoperative photography shows the tumor with pale yellowish color. B : Final photography after removal of the tumor shows nerve root.

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  Fig. 5 Histology of spinal surgical specimen shows small round cell tumor with extensive necrosis consistent with metastatic rhabdoid tumor (hematoxylin-eosin stain, ×200).

Reference

1. Agranovich AL, Ang LC, Griebel RW, Kobrinsky NL, Lowry N, Tchang SP. Malignant rhabdoid tumor of the central nervous system with subarachnoid dissemination. Surg Neurol. 1992; 37:410–414. PMID: 1631771.

2. Akhtar M, Ali MA, Sackey K, Bakry M, Johnson T. Malignant rhabdoid tumor of the kidney presenting as intraocular metastasis. Pediatr Hematol Oncol. 1991; 8:33–43. PMID: 1851430.

3. Alavi S, Rashidi A, Khatami AR, Arzanian MT. Rhabdoid tumor of the kidney presenting with hemiplegia : report of a case. Pediatr Hematol Oncol. 2007; 24:123–128. PMID: 17454778.

4. Fridley JS, Chamoun RB, Whitehead WE, Curry DJ, Luerssen TG, Adesina A, et al. Malignant rhabdoid tumor of the spine in an infant : case report and review of the literature. Pediatr Neurosurg. 2009; 45:237–243. PMID: 19521139.

5. Huisman TA. Pediatric tumors of the spine. Cancer Imaging. 9 Spec No A:2009; S45–S48. PMID: 19965293.

6. Luo CC, Lin JN, Jaing TH, Yang CP, Hsueh C. Malignant rhabdoid tumour of the kidney occurring simultaneously with a brain tumour : a report of two cases and review of the literature. Eur J Pediatr. 2002; 161:340–342. PMID: 12029454.

7. Palmer NF, Sutow W. Clinical aspects of the rhabdoid tumor of the kidney : a report of the National Wilms' Tumor Study Group. Med Pediatr Oncol. 1983; 11:242–245. PMID: 6310357.

8. Park JH, Jeon SR. Pre- and postoperative lower extremity motor power and ambulatory status of patients with spinal cord compression due to a metastatic spinal tumor. Spine (Phila Pa 1976). 2013; 38:E798–E802. PMID: 23532120.

9. Pollono D, Tomarchia S, Drut R, Ibañez O, Ferreyra M, Cédola J. Spinal cord compression : a review of 70 pediatric patients. Pediatr Hematol Oncol. 2003; 20:457–466. PMID: 14631620.

10. Reinhard H, Reinert J, Beier R, Furtwängler R, Alkasser M, Rutkowski S, et al. Rhabdoid tumors in children : prognostic factors in 70 patients diagnosed in Germany. Oncol Rep. 2008; 19:819–823. PMID: 18288421.

11. Rorke LB, Packer R, Biegel J. Central nervous system atypical teratoid/rhabdoid tumors of infancy and childhood. J Neurooncol. 1995; 24:21–28. PMID: 8523069.

12. Tantawy AA, Ebeid FS, Mahmoud MA, Shepl OE. Spinal cord compression in childhood pediatric malignancies : multicenter egyptian study. J Pediatr Hematol Oncol. 2013; 35:232–236. PMID: 23511492.

13. Tomlinson GE, Breslow NE, Dome J, Guthrie KA, Norkool P, Li S, et al. Rhabdoid tumor of the kidney in the National Wilms' Tumor Study : age at diagnosis as a prognostic factor. J Clin Oncol. 2005; 23:7641–7645. PMID: 16234525.

14. van den Heuvel-Eibrink MM, van Tinteren H, Rehorst H, Coulombe A, Patte C, de Camargo B, et al. Malignant rhabdoid tumours of the kidney (MRTKs), registered on recent SIOP protocols from 1993 to 2005 : a report of the SIOP renal tumour study group. Pediatr Blood Cancer. 2011; 56:733–737. PMID: 21370404.

15. Weeks DA, Beckwith JB, Mierau GW, Luckey DW. Rhabdoid tumor of kidney. A report of 111 cases from the National Wilms' Tumor Study Pathology Center. Am J Surg Pathol. 1989; 13:439–458. PMID: 2543225.