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Chronic subdural hematoma associated with subdural rhabdomyosarcoma: case report.

Nejat F, Keshavarzi S, Monajemzadeh M, Mehdizadeh M, Kalaghchi B

Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran 14155-7854. nejat@sina.tums.ac.ir

OBJECTIVE: Subdural rhabdomyosarcoma is very rare, and even more unusual is the association between these sarcomas and chronic subdural hematoma. In this report, we present a case of subdural rhabdomyosarcoma that developed in a chronic refractory subdural hematoma. CLINICAL PRESENTATION: A 40-day-old boy was admitted with coma and intractable seizure after a head trauma caused by a fall. A subdural hematoma was detected, which later became chronic and refractory to treatment. INTERVENTION: The patient repeatedly underwent different surgical interventions over 2 years. Finally, extensive bilateral frontotemporoparietal craniotomy was performed at the age of 30 months, which revealed a huge subdural mass. The mass and membranes were resected. Pathological examination confirmed the diagnosis of embryonal-type rhabdomyosarcoma. Radiation therapy was performed, but the tumor recurred and the child died at the age of 3 years. CONCLUSION: Whether the subdural hematoma or the tumor was the initial pathology is debatable. We think the sarcoma probably developed gradually because of chronic inflammation and proliferation in the subdural collection.

Published 6 April 2007 in Neurosurgery, 60(4): E774-5; discussion E775.
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