JOURNAL OF SCHOOL OF ADVANCED STUDIES 5 CASE REPORT Dr. Ankita Tamhane 1 , Dr. Samarth Shukla 2 , Dr. Sourya Acharya 3 Dr. Radhika Pagey 4 , Dr. Meena Pangarkar 5 , Dr. Shweta Deulakar 6 , Dr. Anand Pathak 7 , Dr. Sunita Vagha 8 Vol 5 No 1 January to June 2022 Pleural Embryonal Rhabdomyosarcoma in a 2 year old child- a rare case report ABSTRACT : Rhabdomyosarcoma is a disease occurring primarily in infants and children. Most common sites involved are head and neck, urogenital tract and extremies. Other sites for rhabdomyosarcoma are quite rare. Here we present a case of a 2 year old child presenng with breathing difficules due to a pulmonary mass which was diagnosed as Pulmonary Rhabdomyosarcoma. KEY WORDS : Pleural Embryonal Rhabdomyosarcoma, infants and children. INTRODUCTION : Rhabdomyosarcoma (RMS) occurs predominantly in infants and children. Most common sites involved are head and neck, genitourinary tract, and extremies. Primary pulmonary RMS is a rare enty. It accounts for only 0.5% of childhood RMS and 4.4% of childhood pulmonary neoplasms. To the best of our knowledge, only 27 cases have been reported in the English literature[1,2]. We present a rare case of primary pulmonary embryonal rhabdomyosarcoma in a 2 year old girl child. CASE REPORT : A two year old female child from yawatmal district presented with cough and difficulty in breathing since 1-2 months. The paent was referred to primary health care centre and was treated symptomacally for the same. Paent was relieved for few days but again paent started having cough and difficulty in breathing. Her roune acvity was reduced. Appete and weight also decreased. The paent was referred to Department of Paediatrics, Acharya Vinoba Bhave Rural Hospital for further management. The paent was evaluated and was subjected for X ray examinaon in view of cough and dyspnoea. X ray showed bilateral pulmonary infecon. The paent was treated with anbiocs for infecon. However the paent did not show any further improvement. A chest CT was advised and it showed a right pleuropulmonary lesion which was ill defined and measured approximately 3.5 x 3 cm. There was no other pathology elsewhere. Radiology report signed out was Pleuro-pulomonary neoplasm more likely a primary than metastasis. A CT guided tru-cut biopsy was performed and the sample was sent for histopathological examinaon at Department of Pathology, Naonal Cancer Instute, Nagpur. Gross : Mulple ny cores were received longest measuring 0.5 cm in length. They were submied enrely in one block. Microscopy : Secon showed mulple linear cores showing fibrous cores infiltrated by sheets of malignant poorly differenated cells. Individual cells were round with scant cytoplasm and high N:C rao. The report was signed out as poorly differenated malignancy, favors malignant round blue cell tumor and immunohistochemistry was advised [ Figure 1]. Immunohistochemistry : Tumor cells showed diffuse and strong immunoreacvity for Vimenn[Figure 2] , Desmin[Figure 3] and Myo-D1 [Figure 4] while were immunonegave for CD-45, pan-CK, CD117, NKX2.2 and Synapthophysin. Diagnosis of Embryonal Rhbdomyosarcoma(RMS) involving the pleuropulmonary region was signed out. The child was treated with Intergroup rhabdomyosarcoma study group ( IRS ) protocol and is on follow up for the past six months. Department of Pathology, Naonal Cancer Instute, Nagpur DOI:10.54054/jsas.2022512