DOI: https://dx.doi.org/10.18203/issn.2454-2156.IntJSciRep20223035
Published: 2022-11-23

Management challenges of sinonasal alveolar rhabdomyosarcoma in infanthood: case report and literature review

Samuel Oluyomi Ayodele, Bashir Mohammed, Adam Shuaib

Abstract


Alveolar rhabdomyosarcoma (aRMS) is an aggressive soft tissue malignant neoplasm. It’s not known to occur often in the sinonasal region of an infant when compared with other histological types. And due to its aggressive nature in deep-seated locations, it’s often difficult to manage efficiently, thus associated with worse prognosis. In this article, a rare case of an infant with right sided sinonasal aRMS was reported. Eight month old child with two month history of right sided nasal blockage, watery discharge and a growth in the right nose. There was no epistaxis, palatal or neck swelling. On examination, a polypoid mass was completely occupying the right nasal cavity. There were no palpable cervical lymph nodes. Diagnosis of allergic rhinosinusitis with nasal polyposis was made. The mass progressed with associated ipsilateral cheek swelling extending to the nasal bridge. A greyish white, friable mass was biopsied and was diagnosed histologically as aRMS. The child had a debulking surgery and adjuvant chemotherapy. She later developed tumour lysis syndrome and died. Management of infanthood sinonasal aRMS is challenging especially in low socioeconomic region like ours. A multi-disciplinary approach with intensified multimodality therapy is crucial to improving the management outcomes and quality of life. In all, it is advisable to take closer look at any swelling in the paediatric age group by carefully evaluating it with high degree of suspicion, early diagnosis and individualized treatment.

 


Keywords


Alveolar rhabdomyosarcoma, Sinonasal region, Intensified multimodality therapy, Adjuvant chemotherapy, Tumour lysis syndrome

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References


Singh GB, Arora R, Kumar D, Jain M, Puri V. A Rare Case of Congenital Rhabdomyosarcoma with Review of the Literature. Case Rep Otolaryngol. 2013;2013:518952.

Moon HS, Kwon SW, Lee JH. A case of alveolar rhabdomyosarcoma of the ethmoid sinus invading the orbit in an adult. Korean J Ophthalmol. 2006;20(1):70-5.

Chan AK, Hartley A, Grimer RJ, Singh PR, Mahendra P. Rare cancers of the head and neck. In: Watkinson JC, Wailbert R, eds. Stell and Maran’s text book of Head and Neck Surgery and Oncology. 5th ed. United Kingdom: Arnold Hodder; 2012: 801.

Rodriguez-Galindo C, Hill DA, Onyekwere O, Pin N, Rao BN, Hoffer FA, et al. Neonatal alveolar rhabdomyosarcoma with skin and brain metastases. Cancer. 2001;92(6):1613-20.

Lahfaoui M, Benhaddou H. Rare case botryoid rhabdomyosarcomas of the genital tract. About a case in a 30-month-old child. Glob J Cancer Ther. 2020;6(1):7-9.

Kumar P, Indranil M, Saibal P, Subhradev M, Sankar B, Bera P. Rhabdomyosarcoma of nose, nasopharynx and paranasal sinuses. Indian J Otolaryngol Head Neck Surg. 2009;61:317-9.

Rajinder S, Rohaizam J, Irfan M. Alveolar-type rhabdomyosarcoma of nasal cavity and paranasal sinus in adult with pulmonary metastasis: a case report. Egypt J Ear Nose Throat Allied Sci. 2016;17:177-9.

Thompson CF, Kim BJ, Lai C, Grogan T, Elashoff D, John MA, et al. Sinonasal rhabdomyosarcoma: Prognostic factors and treatment outcomes. Int Forum Allergy Rhinol. 2013;3:678-83.

Torres-Peña JL, Ramos Castrillo AI, Mencía-Gutiérrez E, Gutiérrez-Díaz E, Rodríguez-Peralto JL, Bengoa-González Á. Nasal cavity or alveolar paranasal sinus rhabdomyosarcoma with orbital extension in adults: 2 cases. Plast Reconstr Surg Glob Open. 2015;3:414.

Ram H, Gupta S, Mohammad S, Chandra A. Aggressive rhabdomyosarcoma of palate: A case report and literature review. J Orofac Sci. 2014;6:137-40.

Moretti G, Guimarães R, deOliveira KM, Sanjar F, Voegels RL. Rhabdomyosarcoma of the head and neck: 24 cases and literature review. Braz J Otorhinolaryngol. 2010;76(4):533-7.

Bostanci A, Asik M, Turhan M. Pediatric sinonasal rhabdomyosarcoma: A case report. Exp Ther Med. 2015;10(6):2444-6.

Patiroglu T, Isik B, Unal E, Canoz O, Deniz K, Kosemehmetoglu K, et al. Cranial metastatic alveolar rhabdomyosarcoma mimicking hematological malignancy in an adolescent boy. Child’s Nerv Syst. 2014;30(10):1737-41.

Wazir M, Jain AG, FaisalUddin M, Tambunan D. An unusual case of alveolar rhabdomyosarcoma of the neck in an adult patient. Cureus. 2020;12(1):6745.

Nema SK, Singh A, Bhasker H, Bhambani P, Sharma HS, Julka K. Alveolar rhabdomyosarcoma in children with histomorphological review. Int J Res Med Sci. 2014;2:775-8.

Russo I, DiPaolo V, Gurnari C, Mastronuzzi A, DelBufalo F, DiPaolo PL, et al. Congenital rhabdomyosarcoma: a different clinical presentation in two cases. BMC Pediatr. 2018;18:166.

Erkul E, Pinar D, Yilmaz I, Cincik H, Cekin E, Salihoglu M. Rare adult sinonasal embryonal rhabdomyosarcoma with optic involvement. Otolaryngology. 2012;2:118.

ElSanharawi A, Coulibaly B, Bessede JP, Aubry K. Paranasal sinus rhabdomyosarcoma: a rare tumor of poor prognosis. Eur Ann Otorhinolaryngol Head Neck Dis. 2013;130:26-9.

Buwalda J, Blank LE, Schouwenburg PF, Copper MP, Strackee SD, Voûte PA, et al. The AMORE protocol as salvage treatment for non‑orbital head and neck rhabdomyosarcoma in children. Eur J Surg Oncol. 2004;30:884‑92.