Alveolar Rhabdomyosarcoma of the foot metastasizing to the Iris: report of a rare case

BMC Cancer. 2016 Jul 11:16:447. doi: 10.1186/s12885-016-2496-6.

Abstract

Background: Intraocular iris rhabdomyosarcoma is extremely rare, and in the 3 cases reported to date occurred as the primary site of tumour growth. We report a case of rhabdomyosarcoma of the foot metastasizing to the iris.

Case presentation: An 18-year-old white female was referred to the London Ocular Oncology Service for management of a metastatic rhabdomyosarcomatous deposit in the iris, a metastasis from alveolar rhabdomyosarcoma of the foot. She was diagnosed nearly 2 years earlier with the primary sarcoma with extensive systemic spread and treated by resection of the foot lesion and chemotherapy, and achieved a partial remission. The left iris deposit was noted while she was receiving systemic chemotherapy, heralding a relapse. However, anterior uveitis and raised intraocular pressure developed and she was referred to our service for further management. A left iris secondary rhabdomyosarcoma deposit was noticed and in addition a lacrimal gland mass, as indicated by ultrasound B scan of the eye and orbit. The patient was treated with external beam radiotherapy to the globe and orbit, but died 2 months after treatment completion.

Conclusion: Rhabdomyosarcoma of the iris is very rare and was previously documented only as a primary malignancy in this location. We report that secondary spread to the iris can also occur, in this case as the first sign of widely disseminated systemic relapse.

Keywords: Case report; Iris; Metastasis; Rhabdomyosarcoma.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chemotherapy, Adjuvant
  • Fatal Outcome
  • Female
  • Foot Diseases / complications*
  • Foot Diseases / pathology*
  • Humans
  • Iris Neoplasms / diagnosis
  • Iris Neoplasms / radiotherapy
  • Iris Neoplasms / secondary*
  • Rare Diseases / etiology*
  • Rhabdomyosarcoma, Alveolar / secondary*
  • Rhabdomyosarcoma, Alveolar / therapy
  • Ultrasonography
  • Uveitis, Anterior / diagnosis
  • Uveitis, Anterior / etiology
  • Uveitis, Anterior / therapy