FROM INITIAL COMMON BACK PAIN IN A CHILD TO FINAL DIFFUSE METASTATIC RHABDOMYOSARCOMA
Thomas Ferry, Maja Beck-Popovic, Nicolas Von der Weid, S Pernet Fattet, I Felberbaum
Department medico-chirurgical de pediatrie, Lausanne, Switzerland
Abstract

Many children complain of back pain. We report on a 7 year old child who presented with persistent back pain and weakness. On physical examination, the child look tired, pale, without neurological deficit. Standard X-ray and CT of the spine showed multiple compressive fractures. Laboratory analyses revealed hypercalcemia, hyperuricemia, elevated LDH, and discrete thrombocytopenia with otherwise normal hemoglobin and white blood cell. Bone marrow aspiration and biopsy revealed a hypercellular bone marrow infiltrate to 95% by small round blue cells. The cells were negative for Langerhans cell histiocytosis or for leukemia, but positive for markers of rhabdomyosarcoma. The alveolar type was confirmed by cytogenetics.
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