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de Aguiar MCF, de Noronha MS, Silveira RL, Araújo JAD, Werkema FS, Bell D, Caldeira PC. Epithelioid rhabdomyosarcoma: Report of the first case in the jaw. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:e308-e315. [PMID: 32173396 DOI: 10.1016/j.oooo.2020.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 01/03/2020] [Accepted: 01/11/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Epithelioid rhabdomyosarcoma (EpiRMS) is a novel morphologically distinct variant of rhabdomyosarcoma, with an unusually challenging microscopic diagnosis. The occurrence of rhabdomyosarcomas in the jaws is extremely rare. This study presents the first case of EpiRMS in the jaw (mandible) and a literature review of the previous 35 cases of EpiRMS. STUDY DESIGN Here, we report a case of EpiRMS affecting an 18-year-old male patient. Clinical, imaging, microscopic, and immunohistochemical features are discussed and previously reported cases of EpiRMS are reviewed. RESULTS An 18-year-old male patient presented with an exophytic sessile growth on the buccal gingiva, and orthopantomography revealed irregular bone loss. Microscopic analysis showed a large number of cells with epithelioid appearance. Immunohistochemistry staining was positive for desmin, myogenin, MyoD1, smooth muscle actin, h-caldesmon, INI-1, and AE1-AE3. The patient's disease was staged as T4aN1M0 and was treated with surgical excision combined with chemotherapy. CONCLUSIONS The occurrence of RMS in the mandible is rare, and this is the first case of EpiRMS in the jaw. EpiRMS is an unusual histologic subtype that mimics other sarcomas and epithelial malignancies, making diagnosis a challenge. A specific immunohistochemistry panel aids in the diagnosis. EpiRMS has an aggressive course and an unfavorable prognosis.
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Affiliation(s)
- Maria Cássia Ferreira de Aguiar
- Universidade Federal de Minas Gerais, School of Dentistry, Department of Oral Surgery and Pathology, Belo Horizonte, Minas Gerais, Brazil.
| | - Mariana Saturnino de Noronha
- Universidade Federal de Minas Gerais, School of Dentistry, Department of Oral Surgery and Pathology, Belo Horizonte, Minas Gerais, Brazil
| | - Roger Lanes Silveira
- Otorhinolaryngology and Head and Neck Surgery Service, Santa Casa, Belo Horizonte, Minas Gerais, Brazil
| | | | - Flavio Sirihal Werkema
- Otorhinolaryngology and Head and Neck Surgery Service, Santa Casa, Belo Horizonte, Minas Gerais, Brazil
| | - Diana Bell
- Department of Pathology, Division of Pathology/Lab Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Patrícia Carlos Caldeira
- Universidade Federal de Minas Gerais, School of Dentistry, Department of Oral Surgery and Pathology, Belo Horizonte, Minas Gerais, Brazil
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Abstract
Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children and adolescents. Most patients present with a mass in the head and neck region, urogenital region, or with distal extremity involvement. The authors describe a challenging case of a 6-year-old male patient presenting with mandibular RMS. The clinical/radiographic/tomographic evaluations classified the tumor as an advanced stage (stage IV), with a mass of 6.0 cm involving the left side of the mandible and parotid region. The biopsy revealed round, spindled, and pleomorphic cells with hyperchromatic nuclei and rare larger rhabdomyoblasts with eosinophilic cytoplasm. The diagnosis was of embryonal RMS. The patient was referred for treatment with cycles of chemotherapy; however, pulmonary and bone marrow metastasis were identified. Radiotherapy and local surgery with microvascular reconstruction were performed later; however, the patient died after a few months. Early diagnosis is critical for a good prognosis and cure of patients with RMS. Correct diagnosis considering also the histological subtype is important for adequate treatment, which according to the literature is not uniform probably because of the rarity of this neoplasm.
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Sadhasivam V, Sherwood IA, Gutmann JL, Gururaj N, Mahalakshmi V, Doss DM. Spindle cell rhabdomyosarcoma of the anterior mandible manifesting as a periapical lesion of pulpal origin: Case report. AUST ENDOD J 2018; 45:129-134. [DOI: 10.1111/aej.12267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Vanitha Sadhasivam
- Department of Conservative Dentistry and Endodontics CSI College of Dental Sciences Madurai Tamil Nadu India
| | - I. Anand Sherwood
- Department of Conservative Dentistry and Endodontics CSI College of Dental Sciences Madurai Tamil Nadu India
| | - James L. Gutmann
- Restorative Sciences/Endodontics Texas A&M University College of Dentistry Dallas Texas USA
| | - N. Gururaj
- Department of Oral Pathology CSI College of Dental Sciences Madurai Tamil Nadu India
| | - V. Mahalakshmi
- Department of Oral Pathology CSI College of Dental Sciences Madurai Tamil Nadu India
| | - Daffney M. Doss
- Department of Oral Pathology CSI College of Dental Sciences Madurai Tamil Nadu India
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Joy T, Tupkari JV, Hanchate AV, Siwach P. Oral rhabdomyosarcoma in an adult male: A rare case report. J Oral Maxillofac Pathol 2018; 22:285. [PMID: 30158795 PMCID: PMC6097379 DOI: 10.4103/jomfp.jomfp_11_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Rhabdomyosarcoma is a malignant neoplasm of mesenchymal cells, showing varying degrees of striated muscle cell differentiation. It predominantly occurs in children while rarely found in adults and involvement of the oral cavity accounts for only 10%-12% of all head-and-neck cases. Herewith, we present a rare case of spindle cell rhabdomyosarcoma in a 52-year old male, involving the mandibular gingiva, and describe the clinical, radiological, histopathological and immunohistochemical findings.
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Affiliation(s)
- Tabita Joy
- Department of Oral Pathology and Microbiology, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Jagdish Vishnu Tupkari
- Department of Oral Pathology and Microbiology, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Amrut V Hanchate
- Department of Oral Pathology and Microbiology, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Pooja Siwach
- Department of Oral Pathology and Microbiology, Government Dental College and Hospital, Mumbai, Maharashtra, India
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Otmani N, Khattab M. Advanced Orofacial Rhabdomyosarcoma: A Retrospective Study of 31 Cases. Int Arch Otorhinolaryngol 2016; 20:207-11. [PMID: 27413400 PMCID: PMC4942288 DOI: 10.1055/s-0035-1570117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 09/28/2015] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma encountered in childhood and adolescence. Early diagnosis of pediatric cases is critical to improving outcomes, especially when socioeconomic status and geographical access to specialist services can reduce opportunities for early cancer detection and treatment. OBJECTIVE The objective of this study is to determine factors that can delay referral and treatment in specialist pediatric oncology center upon our population specificities. METHODS This retrospective study involved 31 children between 2003 and 2013. Children affected by histologically confirmed RMS occurring as a primary lesion in the orofacial area were included. RESULTS The median age was 8 ± 4.22 years (range: 3 months - 15 years). The male to female ratio was 1.8:1. Most of the patients had advanced stage disease at presentation (81.7% group had 3-4 pretreatment staging) with parameningeal involvement in 80.6% of the cases. The 2-year event-free survival rate was 17.7 ± 7.8% for all the patients. Delay of admission to our unit and abandonment of treatment seem to be important factors for the dismal prognosis. CONCLUSION Patient's location, socioeconomic status and health care coverage have had an impact on longer delays in seeking care and on follow-up. More studies are needed for implementation of a better management practices and a better supportive care upon specificities of our population.
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Affiliation(s)
- Naima Otmani
- Pediatric Hematology and Oncology Unit, Children's Hospital of Rabat, Rabat, Morocco
| | - Mohamed Khattab
- Pediatric Hematology and Oncology Unit, Children's Hospital of Rabat, Rabat, Morocco
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Naniwadekar RG, Vekariya MA, Kulkarni SR, Pednekar AS, Gupta V. Embryonal Rhabdomyosarcoma (RMS) of Retroperitoneum in Young Child. J Clin Diagn Res 2015; 9:PJ03-4. [PMID: 25964885 DOI: 10.7860/jcdr/2015/11933.5701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 02/08/2015] [Indexed: 11/24/2022]
Affiliation(s)
- R G Naniwadekar
- Associate Professor, Department of General Surgery, Krishna Institute of Medical Sciences University and Research Centre , Karad, Maharashtra, India
| | - Mayank A Vekariya
- P.G. Resident, Department of General Surgery, Krishna Institute of Medical Sciences University and Research Centre , Karad, Maharashtra, India
| | - S R Kulkarni
- Professor, Department of General Surgery, Krishna Institute of Medical Sciences University and Research Centre , Karad, Maharashtra, India
| | - Akshay S Pednekar
- P.G. Resident, Department of General Surgery, Krishna Institute of Medical Sciences University and Research Centre , Karad, Maharashtra, India
| | - Vaibhav Gupta
- P.G. Resident, Department of General Surgery, Krishna Institute of Medical Sciences University and Research Centre , Karad, Maharashtra, India
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Abstract
Rhabdomyosarcoma (RMS), a tumor of skeletal muscle origin, is the second most common soft tissue sarcoma encountered in childhood after osteosarcoma. The common sites of occurrence are the head and neck region, genitourinary tract, retroperitoneum, and to a lesser extent, the extremities. Site predilections in the oral cavity are a soft palate, maxillary sinus and alveolus, posterior mandibular region, cheek and lip, and possibly tongue. RMS is a highly malignant tumor with extensive local invasions and early hemorrhagic and lymphatic dissemination. Despite aggressive approaches incorporating surgery, dose-intensive combination chemotherapy, and radiation therapy, the outcome for patients with metastatic disease remains poor. Here, we report a case of oral RMS in a 1-year-old child and describe the clinical, radiological, histopathological, and immunohistochemical findings.
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Affiliation(s)
- S P Shrutha
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - G B Vinit
- Department of Oral and Maxillofacial Surgery, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
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8
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Tandon A, Sethi K, Pratap Singh A. Oral rhabdomyosarcoma: A review. J Clin Exp Dent 2012; 4:e302-8. [PMID: 24455040 PMCID: PMC3892211 DOI: 10.4317/jced.50926] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 08/25/2012] [Indexed: 01/08/2023] Open
Abstract
Rhabdomyosarcoma (RMS) is a rare malignant soft tissue neoplasm comprised of cells derived from the primitive mesen¬chyme. About 35% of RMS arises in the head and neck, are are classified as parameningeal and non-parameningeal forms. These are the most common soft tissue sarcoma of the children, adolescents and young adults. Their etiopathogenesis and its molecular relevance have been emphasized. The first line of treatment is radical excision and this is usually supplemented by radiotherapy. It is believed that adjunct combination chemotherapy may greatly improve the prognosis. Inadequately treated tumours grow in an infiltrative manner and recur in a high percentage of cases. Bone does not constitute an effective barrier to the growth of the tumour and bone invasion is a frequent finding in head and neck rhabdomyosarcomas. Key words:Rhabdomyosarcomas, botryoid, spindle, alveolar, sarcomas, undifferentiated.
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Affiliation(s)
- Ankita Tandon
- Assistant Professor, Department of Oral Pathology & Microbiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Kanika Sethi
- Senior Lecturer, Department of Oral Pathology & Microbiology, Indraprastha Dental, College & Hospital, New Delhi, India
| | - Anand Pratap Singh
- Senior Lecturer, Department of Oral Medicine & Radiology, Rungta College of Dental Sciences and Research, Kohka-Kurud Road, Bhilai-Durg, India
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9
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Abstract
Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children under 15 years of age and rare among persons older than 45 years of age. It is considered to result from malignant transformation of primitive mesenchymal cells. Although it has a relative predominance for head and neck region, it is found less often in oral cavity. Here we report a case of RMS of mandible in an adult patient, which was initially diagnosed as carcinosarcoma. Clinical and pathologic findings are described, which were confirmed by histochemical and immunohistochemical stains.
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Affiliation(s)
- Kundendu Arya
- Departments of Oral Pathology and Microbiology, Mahatama Gandhi Dental College and Hospital, RIICO, Sitapura, Jaipur, Rajasthan, India
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11
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Fatusi OA, Ajike SO, Olateju SO, Adebayo AT, Gbolahan OO, Ogunmuyiwa SA. Clinico-epidemiological analysis of orofacial rhabdomyosarcoma in a Nigerian population. Int J Oral Maxillofac Surg 2009; 38:256-60. [PMID: 19153030 DOI: 10.1016/j.ijom.2008.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2008] [Revised: 04/21/2008] [Accepted: 12/01/2008] [Indexed: 11/16/2022]
Abstract
Rhabdomyosarcoma (RMS) is a malignant soft tissue neoplasm, with varying degrees of striated muscle cell differentiation and a relative predilection for the head and neck region. The objectives of this study were to determine the clinical and histological patterns of RMS, to assess the sociodemographic profile of reported RMS cases, and to highlight the management challenges and outcomes of these cases in a country lacking resources such as Nigeria. Patients diagnosed with RMS, based on clinical and histological evaluation, and recorded in the cancer registry of two maxillofacial centres in Nigeria were reviewed. 21 patients met the inclusion criteria for this study. Their ages ranged from 24 days to 42 years. In all of them multiple anatomical sites were involved. The primary site of the lesion could not be determined. Embryonal and alveolar subtypes were mainly found in the maxilla. There was no statistically significant association between the site of the lesion and the histological type (p=0.39). The patients' age was statistically significantly associated with the histological type (p=0.008). Most patients reported at an advanced stage, contributing to the poor prognosis and management outcome of cases evaluated.
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Affiliation(s)
- O A Fatusi
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
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12
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Ahmed AA, Nava VE, Pham T, Taubenberger JK, Lichy JH, Sorbara L, Raffeld M, Mackall CL, Tsokos M. Ewing sarcoma family of tumors in unusual sites: confirmation by rt-PCR. Pediatr Dev Pathol 2006; 9:488-95. [PMID: 17163788 DOI: 10.2350/06-01-0007.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2006] [Accepted: 04/07/2006] [Indexed: 11/20/2022]
Abstract
Ewing sarcoma family tumors originating in the palate or adrenal gland are extremely rare and may cause difficulty in diagnosis. More common tumors primary to these sites need to be excluded before one arrives at the correct diagnosis. We have recently diagnosed 2 such cases. The 1st case was that of a 24-year-old woman who presented with a swelling in the right side of the hard palate. The 2nd case was diagnosed in a 28-year-old woman who presented with a mass in the right adrenal gland. In both cases, the diagnosis of Ewing sarcoma family of tumors was confirmed by immunohistochemical studies and reverse transcriptase-polymerase chain reaction (RT-PCR). The hard palate case is the 1st and the adrenal gland the 3rd case of Ewing sarcoma family of tumors arising in these sites, in which the diagnosis was confirmed by RT-PCR and/or cytogenetics. Accurate diagnosis of Ewing sarcoma family of tumors is crucial for the management of patients, and when found in such rare locations, diagnosis should be supported by immunohistochemical and/or molecular genetic studies.
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Affiliation(s)
- Atif A Ahmed
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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13
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Shetty K, Tuft H. Dental management of the pediatric post radiation therapy—rhabdomyosarcoma patient: Case reports and review of literature. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/j.ooe.2005.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Magro G, Di Benedetto A, Sanges G, Scalisi F, Alaggio R. Rhabdomyomatous mesenchymal hamartoma of oral cavity: an unusual location for such a rare lesion. Virchows Arch 2005; 446:346-7. [PMID: 15726403 DOI: 10.1007/s00428-004-1196-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2004] [Accepted: 12/06/2004] [Indexed: 11/24/2022]
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Baldi A, Nicoletti G, Colella G, Pia Di Marino M, Persichetti P. Embryonal rhabdomyosarcoma of the tongue in old age. Oral Oncol 2004; 40:450-2. [PMID: 14969826 DOI: 10.1016/j.oraloncology.2003.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2003] [Accepted: 09/18/2003] [Indexed: 10/26/2022]
Abstract
Rhabdomyosarcoma represents the most common soft tissue sarcoma of patients under 15 years of age, but it is definitely rare in subjects older than 45. A very rare case of embryonal type rhabdomyosarcoma of the tongue in a 65-year-old man is reported. The adult patient was treated with surgery and post-operative adjuvant radiotherapy and is disease-free at 48 months of follow-up. TUNEL analysis showed that apoptosis was present in 10% of the cells, thus suggesting that an high number of apoptotic cells may represent an indicator of good prognosis for this malignancy.
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Affiliation(s)
- Alfonso Baldi
- Department of Biochemistry "F Cedrangolo", Second University of Naples, 80138 Naples, Italy.
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16
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Weber AL, Romo L, Hashmi S. Malignant tumors of the oral cavity and oropharynx: clinical, pathologic, and radiologic evaluation. Neuroimaging Clin N Am 2003; 13:443-64. [PMID: 14631684 DOI: 10.1016/s1052-5149(03)00037-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Carcinomas of the oral cavity and oropharynx constitute approximately 2% to 5% of head and neck cancers. Alcohol abuse and tobacco chewing, including chewing Shamma, predispose individuals to the development of cancer in the oral cavity. CT and MR imaging are best suited in the evaluation of cancer of the oral cavity and oropharynx. CT in the axial and coronal planes with 3- to 5-mm sections is the primary modality and is best in the evaluation of bony erosion of the mandible and maxilla. Furthermore, lymph node metastases in the neck are optimally evaluated by contrast CT with 5-mm axial sections. MR imaging is preferred for soft tissue assessment because of the greater contrast resolution. It is therefore the first modality in the assessment of tongue carcinomas, oropharyngeal cancer, and tonsillar lesions. The MR examination should be performed with thin-section imaging, applying T1, T2, and T1-GD-DTPA in the axial and coronal planes, with sagittal sections added for paramidline lesions involving the tongue, lips, anterior floor of the mouth, subdivided according to anatomic locations. The local spread, lymph node metastases, prognosis, and therapeutic approaches vary with the location of the lesion represented by a carcinoma either squamous or undifferentiated in 90% of cases. Some malignant lesions may mimic a benign tumor, such as the adenoid cystic or mucoepidermoid carcinoma. Histopathologic diagnosis is therefore necessary for the final diagnosis before treatment by surgery or radiotherapy. PET scanning is indicated in the following instances: in search of an unknown primary tumor in patients who have a neck mass secondary to carcinoma, if a recurrent carcinoma may be present, when there are metastatic N0 lymph nodes in the neck, or where CT is inconclusive for metastatic lymph nodes in the neck.
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Affiliation(s)
- Alfred L Weber
- Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA.
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Chigurupati R, Alfatooni A, Myall RWT, Hawkins D, Oda D. Orofacial rhabdomyosarcoma in neonates and young children: a review of literature and management of four cases. Oral Oncol 2002; 38:508-15. [PMID: 12110348 DOI: 10.1016/s1368-8375(01)00087-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Rhabdomyosarcoma (RMS) is an aggressive malignant skeletal muscle neoplasm arising from embryonal mesenchyme. It accounts for over 50% of all pediatric soft tissue sarcomas. The head and neck region is the most common site for this tumor in children. Neonatal presentation of this tumor is rare. We present the management of one neonatal case and three additional cases of orofacial RMS in children under the age of 7 years. All four patients were seen in the department of oral and maxillofacial surgery at Children's Hospital and Regional Medical Center (CHRMC) in Seattle between 1992-2000. Three of the four cases were alveolar RMS and one was botryoid sub-type of embryonal RMS. Three patients were treated with a combination of surgery, chemotherapy and radiation, while the patient with botryoid RMS was treated with surgery and chemotherapy only. The patient with congenital RMS died at 2.5 years of age due to recurrent metastatic disease. The other three patients are alive without evidence of recurrent with a mean follow up was 5.5 years (range 2.5-8.5 years). We discuss the current management, diagnosis, biological behavior, histopathology, prognosis and survival of head and neck RMS in neonates and young children.
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Affiliation(s)
- R Chigurupati
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Washington, Seattle, USA
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Al-Khateeb T, Bataineh AB. Rhabdomyosarcoma of the oral and maxillofacial region in Jordanians: a retrospective analysis. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 93:580-5. [PMID: 12075208 DOI: 10.1067/moe.2002.123860] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The objective was to study the clinicopathologic features of rhabdomyosarcoma (RMS) of the oral and maxillofacial region in Jordanians. STUDY DESIGN Data were collected from records of patients treated between 1989 and 2000 at the Maxillofacial Unit of Jordan University of Science and Technology. The main outcome measures were age, gender, location, stage of disease, histopathologic type, treatment received, follow-up period, and eventual outcome. RESULTS Nine patients with RMS aged 4 to 17 years were found, with a male to female ratio of 2:1. Six (67%) bony sites and 7 (78%) soft tissue sites were involved. The extent of disease was locoregional in 8 (89%) cases, nodal in 3 (33%) cases, and distant metastatic in 2 (22%) cases. The Intergroup Rhabdomyosarcoma Study classification of clinical groups was as follows: 2 (22%) cases in stage II, 5 (56%) cases in stage III, and 2 (22%) cases in stage IV. The histopathologic types found were 6 (67%) embryonal, 2 (22%) alveolar, and 1 (11%) undifferentiated. Triple agent chemotherapy was used in the treatment of 8 cases, singly or in combination with surgery or radiotherapy. Two patients are still alive, and 5 patients have died of disease. CONCLUSIONS The clinicopathologic features of maxillofacial RMS in this group of Jordanians are different from those of people from other countries. Further studies are needed to have a better understanding of the behavior of RMS in the oral and maxillofacial area.
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Reino AJ. Factors in the pathogenesis of tumors of the sphenoid and maxillary sinuses: a comparative study. Laryngoscope 2000; 110:1-38. [PMID: 11037807 DOI: 10.1097/00005537-200010001-00001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES/HYPOTHESIS To explain the processes that lead to the development of tumors in the maxillary and sphenoid sinuses. STUDY DESIGN A 32-year review of the world's literature on neoplasms of these two sinuses and a randomized case-controlled study comparing the normal mucosal architecture of the maxillary to the sphenoid sinus. METHODS Analysis of a 32-year world literature review reporting series of cases of maxillary and sphenoid sinus tumors. Tumors were classified by histological type and separated into subgroups if an individual incidence rate was reported. Histomorphometry of normal maxillary and sphenoid sinus mucosa was performed in 14 randomly selected patients (10 sphenoid and 4 maxillary specimens). Specimens were fixed in 10% formalin, embedded in paraffin, and stained with periodic acid-Schiff (PAS) and hematoxylin. Histomorphometric analysis was performed with a Zeiss Axioscope light microscope (Carl Zeiss Inc., Thornwood, NY) mounted with a Hamamatsu (Hamamatsu Photonics, Tokyo, Japan) color-chilled 3 charge coupled device digital camera. The images were captured on a 17-inch Sony (Sony Corp., Tokyo, Japan) multiscan monitor and analyzed with a Samba 4000 Image Analysis Program (Samba Corp., Los Angeles, CA). Five random areas were selected from strips of epithelium removed from each sinus, and goblet and basal cell measurements were made at magnifications x 100 and x 400. RESULTS The literature review revealed that the number and variety of tumors in the maxillary sinus are much greater than those in the sphenoid. The incidence of metastatic lesions to each sinus is approximately equal. No recognized pattern of spread from any particular organ system could be determined. On histomorphometric study there were no statistically significant differences between the sinuses in the concentration of goblet cells, basal cells, or seromucinous glands. CONCLUSIONS Factors involved in the pathogenesis of tumors of the maxillary and sphenoid sinuses include differences in nasal physiology, embryology, morphology, and topography. There are no significant histological differences in the epithelium and submucous glands between the two sinuses to explain the dissimilar formation of neoplasms.
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Affiliation(s)
- A J Reino
- Manhattan Ear, Nose and Throat Associates, New York, New York 10128, USA
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20
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Sekhar MS, Desai S, Kumar GS. Alveolar rhabdomyosarcoma involving the jaws: a case report. J Oral Maxillofac Surg 2000; 58:1062-5. [PMID: 10981991 DOI: 10.1053/joms.2000.8754] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Pandey M, Thomas G, Mathew A, Abraham EK, Somanathan T, Ramadas K, Iype EM, Ahamed IM, Sebastian P, Nair MK. Sarcoma of the oral and maxillofacial soft tissue in adults. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2000; 26:145-8. [PMID: 10744932 DOI: 10.1053/ejso.1999.0758] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIMS Sarcoma occurring in oral and maxillofacial soft tissue is rare. This study was carried out to evaluate the prevalence of oral soft tissue sarcoma and to record its natural history and survival. METHODS Retrospective analysis of the patients with histologically proven oral and maxillofacial soft tissue sarcoma treated at the Regional Cancer Centre (RCC), Trivandrum, betweeen 1990-1998 was carried out. RESULTS During this period, ten cases of oral and maxillofacial sarcomas were registered. Three lesions were located on the cheek mucosa, two on the tongue and two on the mandibular alveolus, while there was one lesion each in the parotid region, maxilla and face (NOS). Mean age at presentation was 31.3+/-14.1 years (range 15-54 years). Seven of the patients (70%) were males. There were three cases of rhabdomyosarcoma (RMS), three cases of spindle cell sarcoma and one case each of angiosarcoma, haemangioendothelioma, malignant schwannoma and malignant fibrous histiocytoma (MFH). All the patients were treated with surgery as a primary modality. Median follow-up time was 30 months (range 5-94 months). An overall srvival of 87.5% at 5 years was observed; however, 5-year disease free survival was 60.0% (95% CI 19.5-85.2). CONCLUSIONS Soft tissue sarcomas are of comparatively less frequent occurrence in oral and maxillofacial soft tissue than in other tissues. A good survival rate can be achieved by multimodality treatment.
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Affiliation(s)
- M Pandey
- Department of Surgical Oncology, Regional Cancer Centre, Trivandrum, India.
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22
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Affiliation(s)
- C B Fowler
- Oral & Maxillofacial Pathology Services, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, Texas, USA
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23
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Abstract
A lingual rhabdomyosarcoma was diagnosed in a six-year-old Staffordshire bull terrier with clinical signs of dysphagia. The unsuccessful response to initial chemotherapy, to surgical resection and subsequent surgical resection and radiation therapy is documented. The accurate diagnosis and prognosis of such tumours is also discussed. Lingual rhabdomyosarcoma has not previously been reported in the dog.
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Affiliation(s)
- B D Lascelles
- Department of Clinical Veterinary Science, University of Cambridge
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24
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Mafee MF, Pai E, Philip B. Rhabdomyosarcoma of the orbit. Evaluation with MR imaging and CT. Radiol Clin North Am 1998; 36:1215-27, xii. [PMID: 9884698 DOI: 10.1016/s0033-8389(05)70241-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Rhabdomyosarcoma is the most common primary orbital malignancy of childhood. It can present insidiously, mimicking other (benign) processes clinically and radiographically. CT and MR imaging are crucial in the diagnostic evaluation, treatment planning, and follow-up monitoring of the disease. Such imaging, especially when contrast is used, can accurately detect and state the extent of tumor involvement.
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Affiliation(s)
- M F Mafee
- Department of Radiology, University of Illinois at Chicago, USA
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25
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Goto TK, Yoshiura K, Tanaka T, Kanda S, Ozeki S, Ohishi M, Kobayashi I, Matsuo K. A follow-up of rhabdomyosarcoma of the infratemporal fossa region in adults based on the magnetic resonance imaging findings: case reports. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1998; 86:616-25. [PMID: 9830658 DOI: 10.1016/s1079-2104(98)90356-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Two adult patients with rhabdomyosarcoma of the infratemporal fossa region were evaluated by computed tomography and magnetic resonance imaging both before and after treatment. Successful treatment accompanied by reduction of the tumor mass as a result of chemotherapy was demonstrated in one patient. In the other patient a subsequent increase in the tumor mass was documented. Information on not only the size but also the internal architecture of the tumor may be useful when tumor response to therapy is being investigated. Magnetic resonance imaging is recommended as a method for outcomes evaluation in adult rhabdomyosarcoma cases.
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Affiliation(s)
- T K Goto
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kyushu University, Fukuoka, Japan
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26
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27
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Pavithran K, Doval DC, Mukherjee G, Kannan V, Kumaraswamy SV, Bapsy PP. Rhabdomyosarcoma of the oral cavity--report of eight cases. Acta Oncol 1998; 36:819-21. [PMID: 9482689 DOI: 10.3109/02841869709001364] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- K Pavithran
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India
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28
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Abstract
PURPOSE To evaluate the correlation between the gross imaging evidence of an aggressive masticator space (MS) tumor and the presence of such a MS malignancy. MATERIALS AND METHODS Thirty patients were identified retrospectively who had a malignancy that either arose in or metastasized to the MS, had pathologic verification of the diagnosis, and had magnetic resonance (MR) and/or computed tomographic (CT) images. Specifically evaluated was the presence or absence of gross imaging evidence of mandibular erosion and the integrity of the medial MS fascia as evaluated by a smooth margin between this fascia and the parapharyngeal space fat. RESULTS Of the 30 tumors, 28 were high-grade malignancies and 2 were histiocytoses. Of these, 5 had mandibular erosion and violation of the MS fascia, 19 had bone erosion with an intact fascia, 4 had neither bone erosion nor fascial violation (3 of these patients were under the age of 20 years), and 2 had fascial violation with no bone erosion. CONCLUSIONS In 76.7% of patients with a malignancy arising in the MS, on imaging the medial MS fascia was grossly intact. There were 4 patients with MS malignancy and neither violation of the medial MS fascia nor mandibular bone erosion. Thus, these imaging findings may not be good criteria to evaluate the presence of a high-grade MS malignancy, especially if the patient is under the age of 20 years, in which age group MS sarcomas are more likely to arise.
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Affiliation(s)
- P M Som
- Department of Radiology, Mount Sinai Hospital, New York, NY 10029, USA
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29
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Kapadia SB, Dhir R, Fujii H, Dickman PS, Wollman MR, Johnson JT, Barnes L. Botryoid embryonal rhabdomyosarcoma of Stensen's duct. Am J Otolaryngol 1996; 17:127-32. [PMID: 8820189 DOI: 10.1016/s0196-0709(96)90009-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- S B Kapadia
- Department of Pathology, Presbyterian-University Hospital, Pittsburgh, PA 15213-2582, USA
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30
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Meehan S, Davis V, Brahim JS. Embryonal rhabdomyosarcoma of the floor of the mouth. A case report. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1994; 78:603-6. [PMID: 7838467 DOI: 10.1016/0030-4220(94)90172-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Rhabdomyosarcoma is a neoplasm composed of striated muscle. One of the most common types of soft tissue mesenchymal tumors in infants, children, and adolescents, rhabdomyosarcoma was considered an almost uniformly fatal cancer as recently as 30 years ago. Presently a multimodal approach consisting of surgery, radiation, and chemotherapy has significantly improved the outlook for the patient with rhabdomyosarcoma. This article presents a case of intraoral rhabdomyosarcoma that was initially poorly controlled because of a lack of patient compliance. After proper treatment, the cancer went into remission. The patient remained cancer-free for 7 years, albeit with significant morbidity. This case demonstrates the significantly improved prognosis achieved with multimodal therapy.
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Affiliation(s)
- S Meehan
- National Institute of Dental Research, Clinical Investigations and Patient Care Branch
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31
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Doval DC, Kannan V, Acharya RS, Mukherjee G, Shenoy AM, Bapsy PP. Rhabdomyosarcoma of the tongue. Br J Oral Maxillofac Surg 1994; 32:183-6. [PMID: 8068593 DOI: 10.1016/0266-4356(94)90107-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Although rhabdomyosarcoma (RMS) has a predilection for the head and neck region its occurrence in the tongue is uncommon. We report 2 cases of RMS of the tongue, 1 paediatric and 1 adult patient. The child who had RMS of the alveolar type involving anterior two-thirds of the tongue was treated with surgery and chemotherapy and is disease-free at 84 months of follow-up. The adult patient had locally extensive embryonal RMS of posterior third of the tongue, received chemotherapy and radiotherapy but died with progressive disease at 24 months of follow-up.
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Affiliation(s)
- D C Doval
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India
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32
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Nakhleh RE, Swanson PE, Dehner LP. Juvenile (embryonal and alveolar) rhabdomyosarcoma of the head and neck in adults. A clinical, pathologic, and immunohistochemical study of 12 cases. Cancer 1991; 67:1019-24. [PMID: 1991249 DOI: 10.1002/1097-0142(19910215)67:4<1019::aid-cncr2820670426>3.0.co;2-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Sites in the head and neck region (orbit, nasopharynx, nasal cavity, etc.) are among the most frequent locations for juvenile (embryonal and alveolar) rhabdomyosarcomas in patients younger than 15 years; however, comparable neoplasms in adults are very uncommon. A clinicopathologic and immunohistochemical study of 12 juvenile rhabdomyosarcomas in patients between the ages of 18 and 36 years is presented. There was a female:male ratio of 2:1. The orbit with or without contiguous paranasal sinus involvement, nasal cavity, sphenoid sinus, middle ear, and soft tissues of the neck and preauricular region were the primary sites. Seven tumors involved a parameningeal site and eight cases were alveolar rhabdomyosarcomas which together contributed to the adverse outcome. Only two patients were long-term, disease-free survivors. Six patients have died of tumor and two others are alive with persistent disease. Immunohistochemical study in 11 cases demonstrated reactivity for vimentin and muscle-specific actin (HHF-35) and desmin in ten cases. Juvenile rhabdomyosarcoma rarely presents in the head and neck of adults but should be considered in the differential diagnosis of a small cell neoplasm in patients during the third and fourth decades of life.
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Affiliation(s)
- R E Nakhleh
- Division of Surgical Pathology, University of Minnesota Medical School, Minneapolis
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