Pediatric Hematology/Oncology and ImmunopathologyPediatric Hematology/Oncology and ImmunopathologyВопросы гематологии/онкологии и иммунопатологии в педиатрии1726-17082414-9314Fund Doctors, Innovations, Science for Children43210.24287/1726-1708-2020-19-4-158-164CLINICAL OBSERVATIONSКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯEmbryonal rhabdomyosarcoma with distant spinal cord metastasis: case and MR-imagingЭмбриональная рабдомиосаркома с метастатическим поражением оболочек спинного мозга: диагностический случай и МР-картинаhttps://orcid.org/0000-0003-4164-004XStrumilaN. A.СтрумилаН. А.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0003-1099-9332KrasnovA. S.КрасновА. С.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0001-9594-3930AndrianovM. M.АндриановМ. М.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0001-7317-7104TeresсhenkoG. V.ТерещенкоГ. В.
Russian Federation

Galina V. Tereshchenko, Сand. med. sci., Head of Radiology Department

1 Samory Mashela St., Moscow 117997

Терещенко Галина Викторовна, канд. мед. наук, заведующая рентгенологическим отделением

117997, Москва, ул. Саморы Машела, 1 

radiology@fnkc.ruDmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of the Russian FederationФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава России081220201941581642112202021122020Copyright ©; 2025, «D. Rogachev NMRCPHOI»Copyright ©; 2025, ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России2025«D. Rogachev NMRCPHOI»ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава Россииhttps://creativecommons.org/licenses/by/4.0https://hemoncim.com/jour/article/view/432

Embryonal rhabdomyosarcoma (eRMS) is one of the most common soft tissue sarcomas in children, accounting for 4.5% of all childhood tumors. Half of the eRMS occuring in the head and neck are parameningeal. About 40% of patients with eRMS can develop distant metastases. In patients with intracranial tumors, metastatic spread can occur along the central nervous system (CNS) meninges. The literature describes only 4 clinical cases of eRMS with distant metastases in the spinal cord and along the meninges. Only in two out of these four cases, CSF cytology was positive (meaning that tumor cells were detected in cerebrospinal fluid). Magnetic resonance imaging (MRI) of the central nervous system with contrast enhancement can be used to detect distant metastases in the CNS and meninges. We present a clinical case of a 4-year old girl with parameningeal eRMS. MRI of the CNS performed as part of a diagnostic check-up revealed nodal metastatic foci along the meninges of the spinal cord. In accordance with the treatment protocol, the patient was diagnosed with stage 4 disease and received intensive polychemotherapy resulting in the disappearance of the nodal lesions in the spinal cord and a good prognosis. The parents gave their consent to the use of their child's data, including photographs, for research purposes and in publications.

Эмбриональная рабдомиосаркома (эРМС) является одной из распространенных сарком мягких тканей в детском возрасте и составляет 4,5% всех опухолей. Половина эРМС, возникших в области головы и шеи, имеют параменингеальную локализацию. Около 40% пациентов при данной патологии могут иметь отдаленные метастазы. При интракраниальном распространении метастазирование может происходить по оболочкам центральной нервной системы (ЦНС). В литературе описано 4 клинических случая отдаленных метастазов эРМС в спинной мозг и по его оболочкам. Только в 2 из 4 случаев цитологическое исследование ликвора на опухолевые клетки дало положительный результат. Магнитно-резонансная томография (МРТ) ЦНС с применением контрастного вещества позволяет оценить наличие отдаленных метастазов по оболочкам ЦНС. Нами представлен клинический случай пациентки 4 лет с эРМС параменингеальной локализации, у которой на этапе обследования при проведении МРТ ЦНС были выявлены узловые очаги метастазирования по оболочкам спинного мозга. В соответствии с протоколом лечения была поставлена IV стадия заболевания и проведена интенсивная полихимиотерапия, которая привела к нивелированию очаговых образований в спинном мозге и положительному прогнозу для пациентки. Родители дали согласие на использование информации, в том числе фотографий ребенка, в научных исследованиях и публикациях.

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