The patient was submitted to lung and prostate biopsies which showed pulmonary alveolar proteinosis (PAP) and embryonal rhabdomyosarcoma (fig 1A and B). A radical cystoprostatectomy with an ileal conduit was performed without curative intention due to lymph node metastasis and 1 month later the patient underwent pelvic radiotherapy and doxorubicin-based chemotherapy. The patient refused treatment of the pulmonary disease. There was progression …