Case report of rhabdomyosarcoma in the maternity hospital-Damascus university

ABSTRACT

Rhabdomyosarcoma is the commonest soft tissue cancer of childhood accounting for 5% of all childhood malignancies. The tumor arises from embryonic mesenchymal tissue in any of various sites, the most frequent being head and neck [40%], GU tract [20%], and extremities [18%], the trunk [7%], retroperitoneum [7%] and perineum and other sites [8%]. Rhabdomyosarcomas have many presentations with widely different prognoses and the classification is controversial. Multivariate analysis of prognostic factors agree that the presence or absence of metastasis is the most important prognostic factor. The addition of chemotherapy to radiation therapy and surgery has dramatically improved survival in rhabdomyosarcoma in the last 20 years. R. Kh., a 15 - year old patient, referred to the Maternity Hospital with huge mass in perineum that extended to the left pelvic wall and metastasized to left paraortic lymph nodes compressing left ureter. There was also lung metastasis. Under general anaesthesia the huge mass was removed. Biopsies were taken from left paraortic lymph nodes and left pelvic mass. Left ureter was freed and reinserted in the urinary bladder and colostomy was done. The patient received 6 courses of [VAC], chemotherapy [3] weeks after surgery. At the end of chemotherapy, the rest of perineal mass, pelvic mass and left paraortic nodes disappeared. Only lung metastasis remained stationary. After 4 months a new lung metastasis appeared. The patient was put on Etopside and Ifosfamide chemotherapy