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A case report of malignant triton tumor and literature review on its clinical pathology and PET/CT image analysis

SHI Huazheng;SHOU Yi;LIU Shiyuan;Department of Radiology,Changzheng Hospital Affiliated to Second Military Medical University;Department of PET/CT Center,No.411 Hospital of Chinese People's Liberation Army;  
Objective:To discuss the clinical pathological features and PET/CT imaging characteristics of malignant triton tumor(MTT).Methods:The clinical manifestations,pathological histology features,immunohistochemical results combined with PET/CT imaging findings were retrospectively analyzed in 1 case of right parapharyngeal malignant triton tumor through review of the literature.Results:A female patient of 51 years old presented with pain and numbness on right maxillofacial region and aggravated with time.PET/CT showed a soft tissue mass on the right parapharyngeal space with FDG abnormally accumulation,SUVave is 16.9.Pathological histology revealed differentiation characteristics of rhabdomyoblastic cells in background of spindle or small round never tumor cells,rhabdomyoblastic cell is of medium large,round or ovoid,with abundant eosinophilic cytoplasm and eccentric nuclear.Immunohistochemical results:S-100 were positive for background of nerve sheath cells,in which desmin and vimentin were positive for differentiate rhabdomyoblastic cells.Conclusion:MTT is a kind of rare malignant peripheral nerve tumor accompanied with rhabdomyosarcoma differentiation.Clinical symptoms of patients are not obvious.PET/CT can provide a certain of valued diagnostic information.Pathological histology and immunohistochemical results can afford characteristic information for MTT,and the differentiation diagnosis need to be made with Ewing's scarcoma(ES)/primitive neuroectodermal tumour(PNET),lymphoblastic lymphoma(LBL),rhabdomyosarcoma(RMS) and malignant fibrous histocytoma(MFH).According to PET/CT imaging characteristics,combining with pathological histology and immunochemical results can make a definite diagnosis.
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