Adult Duodenal Pleomorphic Rhabdomyosarcoma

A 73-year-old woman was admitted with severe anemia. An esophagogastroduodenoscopy revealed the presence of a tumor in the second portion of the duodenum (Figure 1); biopsies showed pleomorphic rhabdomyosarcoma (RMS; Figure 2). Phosphotungstic acid-hematoxylin staining highlighted cytoplasmic cross in tumor cells, and immunohistochemical staining demonstrated that the tumor was positive for muscle-specific (desmin) and rhabdomyogenic markers (myoD1 and myogenin), which provided evidence supporting myogenic differentiation (Figure 3). The patient underwent subtotal stomach-preserving pancreaticoduodenectomy without any complications. There has been no tumor recurrence for at least 6 months after surgery.