# Synchronous malignant rhabdoid tumor of the kidney and adrenal neuroblastoma in an infant treated with proton beam therapy: a case report and literature review

**Authors:** Wei Han, Huaida Teng, Junlei Shi, Nan Zhang, Jargal Tumendemberel, Ping Lu, Jie Wang, Jie Zheng, Xinan Liu, Deguang Meng, Shosei Shimizu

PMC · DOI: 10.3389/fonc.2025.1699028 · Frontiers in Oncology · 2026-02-05

## TL;DR

A 4-month-old infant with rare kidney and adrenal tumors was successfully treated with proton beam therapy, preserving organ function and development.

## Contribution

This case highlights proton beam therapy's effectiveness in treating rare pediatric malignancies with minimal developmental risks.

## Key findings

- The patient remained disease-free at 1-year follow-up with preserved renal function.
- Proton beam therapy achieved local control while minimizing late effects in infant malignancies.

## Abstract

This case report and literature review presents a 4-month-old infant with a synchronous malignant rhabdoid tumor of the kidney and adrenal neuroblastoma, an exceptionally rare combination without established treatment guidelines. Following surgical resection, proton beam therapy (14 Gy in 10 fractions) was administered to the abdominal–pelvic tumor bed with stringent organ-sparing objectives. Contemporary literature supports proton beam therapy’s (PBT’s) dosimetric advantages for organ preservation in pediatric abdominal malignancies. At 1-year follow-up, the patient remained disease-free, with preserved renal function and normal skeletal development, supporting PBT’s role in minimizing late effects while achieving local control in infant malignancies when conventional photon radiotherapy would pose substantial developmental risks.

## Linked entities

- **Diseases:** malignant rhabdoid tumor (MONDO:0002728), adrenal neuroblastoma (MONDO:0006076)

## Full-text entities

- **Genes:** SMARCA4 (SWI/SNF related BAF chromatin remodeling complex subunit ATPase 4) [NCBI Gene 6597] {aka BAF190, BAF190A, BRG1, CSS4, MRD16, OTSC12}, SLC17A5 (solute carrier family 17 member 5) [NCBI Gene 26503] {aka AST, ISSD, NSD, SD, SIALIN, SIASD}, SMARCB1 (SWI/SNF related BAF chromatin remodeling complex subunit B1) [NCBI Gene 6598] {aka BAF47, CSS3, INI-1, INI1, MRD15, PPP1R144}, MYCN (MYCN proto-oncogene, bHLH transcription factor) [NCBI Gene 4613] {aka FGLDS1, MODED, MPAPA, MYCNsORF, MYCNsPEP, N-myc}
- **Diseases:** atypical teratoid/rhabdoid tumor (MESH:C000597569), hepatic toxicity (MESH:D056486), asymmetry (MESH:D005146), lymph node metastases (MESH:D008207), abdominal malignancies (MESH:D000007), musculoskeletal disorders (MESH:D009140), Lymph Node (MESH:D000072717), XL (MESH:D000080345), toxicities (MESH:D064420), bone marrow suppression (MESH:D001855), Stages III-IV disease (MESH:D007676), MRT (MESH:D018335), of vertebral (MESH:C535781), neurocognitive impairment (MESH:D019965), cardiovascular dysfunction (MESH:D002318), endocrinopathy (MESH:C567425), abdominal tumors (MESH:D000008), neutropenia (MESH:D009503), scoliosis (MESH:D012600), renal mass (MESH:C536030), Neuroblastoma (MESH:D009447), malignant rhabdoid tumor of the kidney (MESH:D007680), growth-plate disturbance (MESH:D000072042), gait disturbance (MESH:D020233), musculoskeletal growth abnormalities (MESH:D009139), CNS (MESH:D002493), adrenal tumor (MESH:D000310), DM (MESH:D009223), atrophy (MESH:D001284), hepatoblastoma (MESH:D018197), cancers (MESH:D009369), limb length discrepancy (MESH:D007870), renal insufficiency (MESH:D051437), disturbance (MESH:D014832), cognitive, neuroendocrine, growth, and musculoskeletal disorders (MESH:D006130), syndromes (MESH:D013577)
- **Chemicals:** creatinine (MESH:D003404), eosin (MESH:D004801), Hematoxylin (MESH:D006416), H&amp;E (MESH:D006371), ICE (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]
- **Mutations:** p.G638R, c.1912G>A

## Full text

_Full body text omitted from this summary view._ Fetch the complete paper as Markdown: https://tomesphere.com/paper/PMC12918047/full.md

## Figures

5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12918047/full.md

## References

28 references — full list in the complete paper: https://tomesphere.com/paper/PMC12918047/full.md

---
Source: https://tomesphere.com/paper/PMC12918047