Synchronous congenital malignant rhabdoid tumor of the orbit and atypical teratoid/rhabdoid tumor--feasibility and efficacy of multimodal therapy in a long-term survivor.

Abstract

Among infant malignancies, congenital tumors, especially those of the central nervous system (CNS), constitute a rather unique subgroup. Poor survival rates (28% in CNS tumors) may be attributed to the aggressive biology as well as specific therapeutic limitations innate to the young age of affected patients. Our patient developed synchronous congenital tumors: an atypical teratoid/rhabdoid tumor (AT/RT) localized in the right lateral ventricle of the brain and a malignant rhabdoid tumor (MRT) in the soft tissue of the right orbit. A de novo germline chromosomal deletion in 22q encompassing the SMARCB1 gene was detected, prompting the diagnosis of a de novo rhabdoid tumor predisposition syndrome 1 (RTPS1). The patient was reported to the European Rhabdoid Registry (EU-RHAB) and treated according to the Rhabdoid 2007 recommendation. Despite the very young age of the patient, the initially desperate situation of RTPS1, and the synchronous localization of congenital rhabdoid tumors, intensive chemotherapy was well tolerated; the child is still in complete remission 5 years following diagnosis. In conclusion, RTPS1 with congenital synchronous MRTs is not necessarily associated with a detrimental outcome. Intensive multidrug chemotherapy, including high dose chemotherapy, may be feasible and justified.

• Authors: Angela Seeringer, Harald Reinhard, Martin Hasselblatt, Reinhard Schneppenheim, Reiner Siebert, Kerstin Bartelheim, Ivo Leuschner, Michael C Frühwald
• Journal: Cancer genetics (Cancer Genet) Vol. 207 Issue 9 Pg. 429-33 (Sep 2014) ISSN: 2210-7762 [Print] United States
• PMID: 25262118 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Chemical References

• Antineoplastic Agents
• Chromosomal Proteins, Non-Histone
• DNA-Binding Proteins
• SMARCB1 Protein
• SMARCB1 protein, human
• Transcription Factors

Topics

• Antineoplastic Agents (therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Brain Neoplasms (congenital, pathology, therapy)
• Child, Preschool
• Chromosomal Proteins, Non-Histone (genetics)
• Chromosome Deletion
• Chromosomes, Human, Pair 22 (genetics)
• Combined Modality Therapy
• DNA-Binding Proteins (genetics)
• Female
• Humans
• Kidney Neoplasms (congenital, pathology, therapy)
• Neoplasms, Multiple Primary (congenital, genetics, pathology)
• Orbital Neoplasms (congenital, pathology, therapy)
• Rhabdoid Tumor (congenital, pathology, therapy)
• SMARCB1 Protein
• Survivors
• Teratoma (congenital, pathology, therapy)
• Transcription Factors (genetics)