The occurence of second malignant neoplasms in young patients whose primary neoplasm had been controlled is being observed more frequently as survival time increases. The second malignant neoplasms may be due to genetic factors, treatment, or an interaction of both.
A recent study of 414 long-term survivors of childhood cancer estimated the 20-year cumulative probability of a second cancer in patients receiving radiation to be 17%.1 There is also evidence for the occurrence of second malignant neoplasms in patients who have received chemotherapeutic agents.2
We report the case of a patient previously treated for alveolar rhabdomyosarcoma with radiotherapy and multiple chemotherapeutic agents in whom acute granulocytic leukemia (AGL) developed.
Report of a Case.—In March 1973, this 3½-year-old girl complained of right forearm pain and subsequently developed a palpable axillary lymph node. A biopsy specimen of the right forearm and axillary node revealed alveolar rhabdomyosarcoma. The patient received