Histopathology of the surgically excised mass confirmed the diagnosis of ERMS, with tumor cells arranged in sheets of small, round cells with scant eosinophilic cytoplasm and eccentric, small oval nuclei and inconspicuous nucleoli, supported by immunohistochemical staining positive for desmin, myogenin, and MyoD1. The gene discussed is MYOD1; the disease is embryonal rhabdomyosarcoma.