FIGURE 1. The patient’s clinical features
A: Family pedigree. The black symbols represent patients withDICER1 syndrome. Our patient is represented by the red arrow. PPB, pleuropulmonary blastoma; ERMS, embryonal rhabdomyosarcoma; MNG, multinodular goiter. B–C: Pelvic magnetic resonance image of the prostate tumor indicated by arrowheads. T1-weighted images with gadolinium enhancement show a solid mass in the prostate gland that constricts the urethra (B ) and a tumor at the trigone protruding into the intraluminal space of the bladder (C ).D–E: Histology of the prostate tumor unveils two distinct patterns: The first one is characterized by hypocellular proliferation of polygonal cells with eccentric nuclei and eosinophilic cytoplasm with an edematous stroma (D ), whereas the other exhibits a solid proliferation of short spindle cells with nuclear enlargement and hyperchromasia (E ). FG : Histology of the primary pleuropulmonary blastoma (F ) and the first relapse (G ) similar to that of the prostate tumor.