Pancreatic metastasis of cardiac rhabdomyosarcoma diagnosed by fine needleaspiration - A case report

BACKGROUND: Fine needle aspiration (FNA) is a valuable technique in the dia gnosis of soft tissue tumors or their metastases. CASE REPORT: A rhabdomyosarcoma of the left atrium with metastasis to the p ancreas was diagnosed by FNA in a 74-year-old female. The patient presented with dyspnea, weight loss and generalized weakness and was found to have I t cardiac arrhythmia. Magnetic resonance imaging showed a 9-cm mass in the left atrium and anterior mediastinum. Computed tomography (CT) of the abdom en revealed a 2.8-cm nodule within the head of the pancreas. The patient un derwent CT-guided percutaneous aspiration biopsy of the pancreatic mass on the first hospital day and, on the second day, transvenous FNA biopsy of th e intracardiac mass. The cytologic morphology and immunnocytochemistry of t he aspirated material from both sites established a diagnosis of cardiac rh abdomysarcoma with metastasis to the pancreas. CONCLUSION: This is the fifth reported case of rhabdomysarcoma metastatic t o the pancreas and the first in which the diagnosis was made by FNA, thereb y eliminating the need for open biopsy.