• Farideh Nejat, Sepideh Keshavarzi, Maryam Monajemzadeh, Mehrzad Mehdizadeh, and Bita Kalaghchi.
• Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran 14155-7854. nejat@sina.tums.ac.ir
• Neurosurgery. 2007 Apr 1;60(4):E774-5; discussion E775.

ObjectiveSubdural 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 PresentationA 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.InterventionThe 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.ConclusionWhether 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.

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