Clinico-epidemiological analysis of orofacial rhabdomyosarcoma in a Nigerian population

Rhabdomyosarcoma of the oral cavity in children aged 0-2 years: A scoping review

BACKGROUND

The aim of this study was to collect, synthesize, and analyze the clinic-demographic data of rhabdomyosarcoma affecting the oral cavity of young children.

METHODS

The clinical question was "What are the clinical characteristics of oral rhabdomyosarcoma in children aged zero to two years?" Two independent reviewers selected the studies, extracted data, and assessed the methodological quality through the Joanna Briggs Institute Checklist. Descriptive statistics were performed in SPSS. (protocol: osf.io/b9hvy).

RESULTS

Thirty case reports with 41 patients were included (22 males; mean age at diagnosis: 15 months). All studies had some methodological limitations, mainly due to the lack of clarity for a final judgment. More than 70% of the cases affected the tongue or lips. Tumors had a fast growth (mean 2.5 months), usually with red coloration, and variable shape and consistency. Embryonal (63.41%) and alveolar (29.27%) were the most common histological subtypes. Treatment was quite variable but usually included surgery. Most patients (53.66%) were alive without disease at follow-up.

CONCLUSION

Oral rhabdomyosarcoma is rare in children aged 0-2 years without a marked gender predilection. The tumor presents as a fast and infiltrative growth leading to local and/or systemic symptoms, and a favorable prognosis for most patients.

Adult Sinonasal Rhabdomyosarcoma With Spinal Metastasis: A Case Report and Review of the Literature

Rhabdomyosarcoma (RMS) is a malignant soft-tissue tumor mainly seen in the pediatric population. Here, we describe a case of an aggressive sinonasal RMS with distant metastasis in an adult patient. A 51-year-old male presented to the otolaryngology clinic with a unilateral painless neck mass and nasal obstruction. A flexible transnasal endoscope showed a huge fungating mass obstructing more than 80% of the right nasal cavity. A contrasted computed tomography (CT) scan of the paranasal sinuses showed an enhancing soft-tissue density mass involving the right nasal cavity. A biopsy revealed RMS, an embryonal variant. The patient responded well to chemoradiotherapy but later developed spinal metastasis and cord compression. He was admitted for palliative care but died due to cardiopulmonary arrest 10 months after diagnosis. A high index of clinical suspicion for malignancy is required in adult patients with unilateral nasal symptoms.

Tongue Spindle Cell Rhabdomyosarcoma: A Rare Case Report and Literature Review

Rhabdomyosarcoma (RMS) is a malignant soft tissue neoplasm with its origin in the skeletal muscle and is extremely rare in adults. By the World Health Organization (WHO), a new variant of RMS has been classified, i.e. the spindle cell (Sc) and sclerosing (S) RMS. While the Sc-RMS shows intersecting fascicles of nonpleomorphic spindle cells, the S-RMS is characterized by a marked hyalinization in a pseudovascular growth pattern associated with round-to-spindled tumour cells. According to the analysed data, the Sc/S-RMS variant has a worse outcome than other variants. The new classification of the Sc/S-RMS variant is valuable to the clinical practice. There are not many oral Sc/S-RMS cases reported. The aim of this paper is to demonstrate that an early diagnosis, an adequate treatment and a multidisciplinary approach have a positive effect on the prognosis of the patient. In this study, we analyse a new case of Sc-RMS variant in a young adult with an early diagnosis and a favourable outcome as a result of an appropriated multidisciplinary treatment: early surgery, radiotherapy and chemotherapy treatment.

Alveolar rhabdomyosarcoma of maxilla

Rhabdomyosarcoma (RMS), a malignant neoplasm of skeletal muscle origin, is the most common soft tissue sarcoma seen in childhood and adolescence. The most frequent site is the head and neck accounting for 40% of all cases and other involved sites are genitourinary tract, retroperitoneum, and to a lesser extent, the extremities. RMS is relatively uncommon in the oral cavity and the involvement of the jaws is extremely rare. Here, we report a case of 50-year-old female with oral RMS involving maxillary alveolar region with clinical, radiological, histopathological and immunohistochemical findings.

Advanced Orofacial Rhabdomyosarcoma: A Retrospective Study of 31 Cases

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.

Orbito-ethmoidal rhabdomyosarcoma in an adult patient: a case report and review of the literature

We report a patient who presented to the ENT service complaining of nasal obstruction, exophthalmos, edema and ipsilateral facial congestion. Imaging studies revealed an aggressive noncalcified solid mass centered in the left nasoethmoidal region and heterogeneous avid enhancement following contrast media injection. Subsequently, a biopsy confirmed the presence of solid alveolar rhabdomyosarcoma. The patient was treated with chemoradiation therapy for 7 weeks. Due to the advanced stage of the disease, the patient was enrolled in a palliative care and pain control program.

Construction of conditional lentivirus-mediated shRNA vector targeting the human Mirk gene and identification of RNAi efficiency in rhabdomyosarcoma RD cells

Rhabdomyosarcoma is the most common malignant soft tissue tumor in children. It has been demonstrated that Mirk as an activated protein kinase is overexpressed in rhabdomyosarcoma cells, which may be correlated with tumorigenesis. The aim of the present study was to explore the possibility of Mirk gene as a therapeutic target for the treatment of rhabdomyosarcoma, and the use of RNA interference in a temporally and spatially restricted manner to study the function of the target gene would be highly beneficial. To address this problem, a conditional lentivirus-mediated short hairpin RNA targeting human Mirk gene was constructed and employed to reduce endogenous Mirk expression in the rhabdomyosarcoma RD cell line in vitro. The expression of Mirk shRNA in RD cells transduced with this recombinant vector could be tracked with the expression of red fluorescent protein by the administration of doxycycline. A stable transgenic RD line was generated by transducing RD lines with the packaging viral particles. Quantitative PCR and western blot analysis indicated that the mRNA and protein levels of Mirk in the transgenic RD cells were significantly lower compared to those in the controls. In addition, the increasing apoptosis of RD cells induced by silencing of the Mirk gene was also observed. Overall, the results demonstrated that this recombinant vector-based RNAi expression system is an efficient approach to knockdown Mirk gene expression in the rhabdomyosarcoma RD cell line, which could, thereby, provide both a protocol to study the role of Mirk gene in tumor cells and a safer gene therapy in the clinic.

Cytogenetics of primary embryonal rhabdomyosarcoma of the cheek

Rhabdomyosarcoma (RMS) is the most common malignant soft tissue tumour of childhood and has two main subtypes: embryonal and alveolar. The embryonal subtype accounts for most cases in the genitourinary tract and head and neck. Oral presentations are rare, and mainly in the tongue, palate, or cheek. Cytogenetically, alveolar RMS is characterised by the translocation t(2;13)(q35;q14), which plays an important part in diagnosis, but no consistent and unique genetic alterations have been identified in embryonal RMS. It is currently not known whether oral embryonal RMS is similar to those that arise from other sites, as only one cytogenetic report has been published to date. We present the case of a 9-year-old boy with embryonal RMS of the cheek, and discuss the cytogenetic alterations in his case.

Rhabdomyosarcoma of the tongue: report of a case and review of the literature

Rhabdomyosarcomas are the most common soft tissue tumors in children. Head and neck is one of the most frequently affected site. Within the nonparameningeal, nonorbital head and neck region, rhabdomyosarcomas of the tongue are very rare. We present a 2-year-old boy diagnosed with rhabdomyosarcoma of the tongue. The child was treated with complete surgical resection and chemotherapy. He is followed up with no evidence of disease 6 months after termination of therapy. The literature on rhabdomyosarcoma of the tongue is reviewed.

Establishment and characterization of the rhabdomyosarcoma cell line designated NUTOS derived from the human tongue sarcoma: Special reference to the susceptibility of anti-cancer drugs

Primary alveolar type of rhabdomyosarcoma (RMS) tumor tissue was collected from the tongue of a 17-year-old Japanese woman and used to successfully establish a rhabdomyosarcoma cell line, which has been designated NUTOS. The chromosomal distribution revealed that the NUTOS cell line was hyper-tetraploid with chromosomal translocation. The cells were grown in Dulbecco's modified eagle medium/F12 supplemented with 15% fetal bovine serum, 0.1% non-essential amino acids solution (NEAA), 50 microg of streptomycin, 50 U/mL of penicillin and 0.25 microg /mL of Fungizone. The NUTOS shapes included small spindles, large spindles and long, thick multinucleated cells. All three cell types were immunostained with anti-desmin antibody, which is a marker protein for middle sized myofilaments. Furthermore, immunocytochemical staining revealed that the cells were positively immunostained with anti-MyoD, myogenin, alpha-sarcomeric actin, myosin and troponin T. Mitotic figures were only observed in the small spindle cells. These cells were coadunated with each other at the lateral portion of the apex of the cells. Subsequently, these cells grew into large multinucleated cells. Autonomic contractions (approximately 20 times/min) were observed in both the large spindle cells and the large multinucleated cells. NUTOS cells incorporated serotonin from the serum in the growth medium. Histopathological observations of the NUTOS cell grafts in the subcutis of nude mice exhibited characteristics similar to those seen for the primary rhabdomyosarcoma of the tongue. Susceptibility tests for the anti-cancer drugs revealed that NUTOS cells were susceptive to cisplatin, paclitaxel, and docetaxel, but not to adriacin.

A strategy to avoid facial mutilation in orbital embryonal rhabdomyosarcoma

INTRODUCTION

An orbital embryonal rhabdomyosarcoma (RMS) is a rare malignancy in children, but clinical findings are typical. We detail the case of an 8-year-old female with orbital RMS and discuss the therapeutic options.

CASE REPORT

Orbital RMS was apparent with painless exophthalmos of the right globe and diplopia. Head MRI showed tumor masses behind and inferior to the globe. Open biopsy led to the histological diagnosis. Metastasis or infiltration of orbital bone was not observed. Chemotherapy was carried out in accordance with the Cooperative Weichteilsarkom Studie (CWS) 2002 protocol. Tumor regression was detected after the first course of chemotherapy; we decided to excise the residual tumor with preservation of the globe. The CWS 2002 protocol was subsequently completed. Radiotherapy was not done. One year after treatment, RMS recurrence was not observed.

CONCLUSION

After interdisciplinary treatment, mutilation was avoided after exenteration of the orbit or radiation treatment to the growing facial skeleton. That was possible due to excision of the residual tumor in a second step, leading to down-staging of the RMS.