Costello syndrome is a well delineated mental retardation syndrome of
unknown aetiology in which the occurrence of benign tumours, especiall
y papillomata, is recognised. We report two children in whom the diagn
osis of Costello syndrome was made in the first months of life, who bo
th developed a retroperitoneal embryonal rhabdomyosarcoma. Although no
t previously reported, the occurrence of this relatively uncommon chil
dhood tumour in two girls with Costello syndrome suggests that an incr
eased risk of malignancy may be part of this condition. The genetic ba
sis of this susceptibility requires further clarification.