Objective: Subdural rhabdomyosarcoma is very rare, and even more unusual is the association between these sarcomas and chronic subdural hematoma. In this report, we present a case of subdural rhabdomyosarcoma that developed in a chronic refractory subdural hematoma.
Clinical presentation: A 40-day-old boy was admitted with coma and intractable seizure after a head trauma caused by a fall. A subdural hematoma was detected, which later became chronic and refractory to treatment.
Intervention: The patient repeatedly underwent different surgical interventions over 2 years. Finally, extensive bilateral frontotemporoparietal craniotomy was performed at the age of 30 months, which revealed a huge subdural mass. The mass and membranes were resected. Pathological examination confirmed the diagnosis of embryonal-type rhabdomyosarcoma. Radiation therapy was performed, but the tumor recurred and the child died at the age of 3 years.
Conclusion: Whether the subdural hematoma or the tumor was the initial pathology is debatable. We think the sarcoma probably developed gradually because of chronic inflammation and proliferation in the subdural collection.