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A case of probable macrogol allergy in urticaria/angioedema patient

Immunohistochemical study revealed that neoplastic cells were positive for vimentin, desmin, myoglobin and actin, and negative for S100 protein and CD68. Diagnosis: Rhabdomyosarcoma. The abdominal-pelvic CT scan was normal, and a thoracic CT scan showing a large solid lesion in the soft tissues of the right dorsal region, involving the shoulder blade and causing oste olisis, perilesional adenopathy, a nodular lesion in the right upper lobe and a nodular lesion in the right pulmonary hilum. Upon diagnosis of rhabdomyosarcoma with distant metastatic disease, the department of Oncology decided to start treatment with holocraneal radiotherapy to reduce the neurological symptomatology, and chemotherapy with Adriamycin, Ifosfamide and Mesna. The patient died after 2 months of starting with the treatment. Rhabdomyosarcoma is a solid neoplasm, and it constitutes approximately 50% of all the soft tissues neoplasms in children. Adults are rarely affected with two peaks of incidence: young adults and the elderly. The most common anatomic sites of occurrence are, in order of frequency, the head and neck, the genitourinary tract and the extremities. It is classified into four histological types: (i) the embryonic form (60%); (ii) botryoid (6%); (iii) alveolar (30%) and (iv) pleomorphic (1%). It is a tumour with poor prognosis. It often causes nodal metastases and the most affected sites by distant metastases are the lungs and the bones. Cutaneous metastases are very rare, mainly in adults, and there are just two described cases. The main prognosis factors include size and site of the tumour, possibility of resection, age of the patient and histological type. Treatment consists of surgical removal if it is possible, radiotheraphy and polychemotheraphy when the metastatic disease is at a late-stage. The interest of this case is that a systemic tumoral pathology was derived from a skin lesion; the atypical site of metastatic cutaneous lesions and the fast evolution of digital lesions.