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Essetti S, Faraj C, Lahlou I, Chait F, Bahlouli N, Allali N, Haddad SE, Chat L. Vaginal botryoid rhabdomyosarcoma in an infant: A case report and review of the literature. Radiol Case Rep 2024; 19:5794-5797. [PMID: 39308616 PMCID: PMC11416461 DOI: 10.1016/j.radcr.2024.08.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 08/14/2024] [Accepted: 08/18/2024] [Indexed: 09/25/2024] Open
Abstract
Botryoid rhabdomyosarcoma is a rare and aggressive malignancy that primarily affects the female genital tract in children. It arises from embryonal rhabdomyoblasts. The vagina is the most common site, but it can also occur, although rarely, in the cervix or uterine fundus. We report the case of a 2-year-old girl who presented with a rapidly growing mass in the vulvar region. A pelvic MRI revealed a grape-like mass occupying the vaginal lumen, suggestive of botryoid rhabdomyosarcoma. Biopsy of the mass confirmed the diagnosis.
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Affiliation(s)
- Sara Essetti
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina, Hospital, Mohamed V University, Rabat, Morocco
| | - Chaymae Faraj
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina, Hospital, Mohamed V University, Rabat, Morocco
| | - Ihssane Lahlou
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina, Hospital, Mohamed V University, Rabat, Morocco
| | - Fatima Chait
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina, Hospital, Mohamed V University, Rabat, Morocco
| | - Nourrelhouda Bahlouli
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina, Hospital, Mohamed V University, Rabat, Morocco
| | - Nazik Allali
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina, Hospital, Mohamed V University, Rabat, Morocco
| | - Siham El Haddad
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina, Hospital, Mohamed V University, Rabat, Morocco
| | - Latifa Chat
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina, Hospital, Mohamed V University, Rabat, Morocco
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Tua-Caraccia R, Aksenov LI, Fairchild RJ, Leraas H, Rhodin K, Tracy ET, Routh JC. Pediatric urothelial cancer: a cross-sectional descriptive analysis of the National Cancer Database. Transl Androl Urol 2024; 13:769-775. [PMID: 38855584 PMCID: PMC11157383 DOI: 10.21037/tau-23-419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/18/2024] [Indexed: 06/11/2024] Open
Abstract
Background Urothelial cancer is a rare pediatric malignancy; previous analyses suggest lower rates of recurrence and death as compared to adults. We analyzed pediatric bladder cancer information in a national database, hypothesizing that survival would be better in children than adults. Methods We analyzed the 2004-2016 National Cancer Database (NCDB) for children and adolescents (0-18 years) with urothelial bladder cancer. Rhabdomyosarcoma patients were excluded. Assessed variables included TNM staging, pathology, tumor size, surgical procedures, and post-operative re-admissions. Overall survival was defined as months since diagnosis as of last follow-up. Results Of 140 urothelial tumors reported to NCDB between 2004-2016, 75.7% (N=106) were stage 0 at diagnosis, 6.4% (N=9) were stage I, 2.9% (N=4) were stage II and 3.6% (N=5) were stage IV, while 11.4% cases (N=16) were unknown. From available mortality data (121 patients), no patients died after definitive surgical resection. Only 1 mortality was reported at 90 days, although cause of death was reportedly unknown. Three (2.5%) patients were lost to follow-up, and most (96.7%) were alive at 90 days. Conclusions Short-term survival outcomes among children and adolescents with urothelial bladder tumors captured in NCDB are reassuring. Future investigations focused on long-term outcomes and appropriate surveillance in this rare patient cohort are imperative to better guide management options.
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Affiliation(s)
| | - Leonid I. Aksenov
- Department of Urology, Duke University School of Medicine, Durham, NC, USA
| | | | - Harold Leraas
- Department of Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Kristen Rhodin
- Department of Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Elisabeth T. Tracy
- Department of Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Jonathan C. Routh
- Department of Urology, Duke University School of Medicine, Durham, NC, USA
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About a Large Botryoid Rhabdomyosarcoma in a Little Girl: Management Difficulties and Literature Review. Case Rep Obstet Gynecol 2023; 2023:4789851. [PMID: 36743833 PMCID: PMC9897935 DOI: 10.1155/2023/4789851] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 10/08/2022] [Accepted: 01/15/2023] [Indexed: 01/30/2023] Open
Abstract
Background Rhabdomyosarcoma (RMS) is a rare high-grade malignant tumor and the most common soft-tissue sarcoma, which occurs in young girl over 5 years old. Multimodality treatment associating with surgery, chemotherapy, and/or radiotherapy culminate in a >70% overall 5-year survival. This is the first case reported in 30 years of practice in Côte d'Ivoire, low- and middle-income country (LMIC). Objective To summarize clinical data, the significant alternative chemotherapy efficiency and difficulties related to the prognosis evaluation in an LMIC. Case A 2-year-old girl had been examined for a large mass in the vulvar region and clitoris. We carried out a biopsy for histopathologist exam. This allows pathologic, genetic, and biological characterization of nonmetastatic botryoid rhabdomyosarcoma. A multidisciplinary team decision of neoadjuvant chemotherapy was retained combining vincristine, cyclophosphamide, and actinomycin D or alternatively with Adriamycin. After 3 weeks of chemotherapy, significant volumetric reduction of tumor was observed. Yet a surgical removal was proposed but not performed because the patient has no longer consulted our medical center and was lost to follow-up. Therefore, we cannot assess the long-term evolution and prognosis. Conclusion Embryonal RMS (ERMS) of clitoris is a rare malignant tumor of infant. Histology and immunohistochemistry are essential for diagnostic but unavailable in our context. We want to emphasize on the difficulties encountered in treatment and prognosis assessment. The primary free surgical removal of the vulva with adjuvant chemotherapy and/or radiotherapy must then be implemented in our practice.
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Dhanji S, Borregales LD, Janzen NK, Godoy G, Fuller MY, Au JK. Infant prostatic Rhabdomyosarcoma: A diagnostic and therapeutic challenge. Urol Case Rep 2022; 43:102116. [PMID: 35646598 PMCID: PMC9133547 DOI: 10.1016/j.eucr.2022.102116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/04/2022] [Accepted: 05/11/2022] [Indexed: 11/10/2022] Open
Abstract
The following case report describes a case of prostatic rhabdomyosarcoma in a 6-month-old male who presented with urinary retention and constipation. MRI showed a prostatic mass that was displacing the rectum and bladder, leading to bladder outlet obstruction. A suprapubic tube was placed for urinary diversion and a transvesical approach was used for tissue diagnosis. Biopsy confirmed the diagnosis of prostatic rhabdomyosarcoma. Patient underwent chemotherapy regiment with VAC (vincristine, actinomycin D and cyclophosphamide) and subsequently ifosfamide and doxorubicin. Eventually, due to tumor progression, the patient underwent a radical cystoprostatectomy with pelvic lymph node dissection and ileal conduit.
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Li J, Huang Y, Li Y, Liu P, Cheng H, Song H, Sun N, Shamil MA, Zhang W. A Web-Based Prognostic Model for Pediatric Genitourinary Rhabdomyosarcoma: Analysis of Population-Based Cohort With External Validation. Front Public Health 2022; 10:870187. [PMID: 35619827 PMCID: PMC9127601 DOI: 10.3389/fpubh.2022.870187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 03/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background We conduct an analysis of data from the Surveillance, Epidemiology, and End Results (SEER) database, intending to identify prognostic factors of pediatric genitourinary rhabdomyosarcoma (PGU–RMS). Prognostic nomogram and web-based calculator were developed for potential clinical use. Methods Data of PGU–RMS patients were extracted from the SEER database as training and internal validation cohort, patients diagnosed as PGU–RMS from 2001 to 2015 in Beijing Children's Hospital were collected as an external validation cohort. We used log-rank tests to seek risk factors on the overall survival (OS) in the overall SEER cohort, tumor site subgroups, radiation subgroups, and metastasis subgroups. The univariable and multivariate Cox regression analyses were applied to establish the prognosis model. Results A total of 372 PGU-RMS patients in SEER and 84 patients from our center were included. 1-, 3-, and 5-year OS of the overall SEER cohort were 95.8, 82.1, and 78.8%. Subgroup analysis indicated that tumors located in the prostate/bladder were associated with a worse prognosis than the paratesticular, female genital system, and other sites (P < 0.001). Tumors of the T1/T2 stage, without regional lymph node, involvement or metastasis, can benefit from radiotherapy (P < 0.05). For patients without metastasis, younger age, T1/T2 stage, and undergoing radiation were associated with better prognosis (P < 0.05). The prognosis nomogram was well-calibrated, the concordance index (C-index) for the OS prediction was 0.823, 0.803, and 0.768 in training, internal and external validation cohort, the area under the receiver operating characteristic curve for 3-, and 5-year OS were 0.84, 0.84 in the training cohort, 0.90, 0.84 in internal validation cohort and 0.75, 0.80 in the external validation cohort. Decision curve analysis showed good clinical utility. The predictive performance of the nomogram was higher than the Intergroup Rhabdomyosarcoma Study Group (IRSG) pretreatment stage system based on the comparison of overtime C-index, net reclassification index, and integrated discriminatory index (P < 0.001). Conclusion A comprehensive analysis of OS for PGU–RMS patients was conducted based on population cohort. The established prognosis nomogram has been fully validated and evaluated, exhibits better performance than the IRSG pretreatment stage system. Furthermore, a web-based risk calculator was developed to optimize clinical decisions.
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Affiliation(s)
- Jiayi Li
- National Center for Children's Health, Department of Surgical Urology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yangyue Huang
- National Center for Children's Health, Department of Surgical Urology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yunpeng Li
- National Center for Children's Health, Department of Surgical Urology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Pei Liu
- National Center for Children's Health, Department of Surgical Urology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Haiyan Cheng
- National Center for Children's Health, Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Hongcheng Song
- National Center for Children's Health, Department of Surgical Urology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Ning Sun
- National Center for Children's Health, Department of Surgical Urology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Mina Ayad Shamil
- International School, Capital Medical University, Beijing, China
| | - Weiping Zhang
- National Center for Children's Health, Department of Surgical Urology, Beijing Children's Hospital, Capital Medical University, Beijing, China
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Long-term disease-free survival following salvage brachytherapy for recurrent pediatric rhabdomyosarcoma: Two case reports and review of relevant literature. Brachytherapy 2022; 21:494-500. [PMID: 35514002 DOI: 10.1016/j.brachy.2022.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE Rhabdomyosarcoma (RMS) is the most common pediatric soft-tissue sarcoma, mostly involving the genitourinary (GU) tract, head and neck, and extremities. This study reports the long-term outcome of two infants with recurrent GU-RMS who underwent combination therapy with chemotherapy (ChT) and salvage brachytherapy (BT). METHODS AND MATERIALS An 18-month-old girl with vaginal bleeding and a 7-month-old boy with urinary retention presented with a diagnosis of vaginal, and bladder/prostate embryonal RMS, respectively. Surgical resection and ChT were done for both patients. However, both developed local recurrences after one year and subsequently, underwent second-line ChT and salvage interstitial high dose rate BT. RESULTS The clinical target volumes for the first and second patients were treated to a totaldose of 32 Gy in 10 fractions and 35 Gy in 10 fractions, respectively, with two fractions delivered per day with a 6-h interval between fractions. After 9 years of follow-up, both patients are alive with natural growth and no late complication or evidence of recurrence. CONCLUSIONS Our report shows that BT (for patients with no prior history of irradiation) could result in long-term disease-free survival in well-selected pediatric patients with recurrent GU embryonal RMS without inflicting expected adverse effects of external beam radiotherapy.
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de la Nava D, Selvi KM, Alonso MM. Immunovirotherapy for Pediatric Solid Tumors: A Promising Treatment That is Becoming a Reality. Front Immunol 2022; 13:866892. [PMID: 35493490 PMCID: PMC9043602 DOI: 10.3389/fimmu.2022.866892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
Immunotherapy has seen tremendous strides in the last decade, acquiring a prominent position at the forefront of cancer treatment since it has been proven to be efficacious for a wide variety of tumors. Nevertheless, while immunotherapy has changed the paradigm of adult tumor treatment, this progress has not yet been translated to the pediatric solid tumor population. For this reason, alternative curative therapies are urgently needed for the most aggressive pediatric tumors. In recent years, oncolytic virotherapy has consolidated as a feasible strategy for cancer treatment, not only for its tumor-specific effects and safety profile but also for its capacity to trigger an antitumor immune response. This review will summarize the current status of immunovirotherapy to treat cancer, focusing on pediatric solid malignancies. We will revisit previous basic, translational, and clinical research and discuss advances in overcoming the existing barriers and limitations to translate this promising therapeutic as an every-day cancer treatment for the pediatric and young adult populations.
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Affiliation(s)
- Daniel de la Nava
- Health Research Institute of Navarra (IdiSNA), Pamplona, Spain
- Programs in Solid Tumors and Neuroscience, Foundation for the Applied Medical Research, Pamplona, Spain
- Department of Pediatrics, Clínica Universidad de Navarra, Pamplona, Spain
| | - Kadir Mert Selvi
- Health Research Institute of Navarra (IdiSNA), Pamplona, Spain
- Programs in Solid Tumors and Neuroscience, Foundation for the Applied Medical Research, Pamplona, Spain
- Department of Pediatrics, Clínica Universidad de Navarra, Pamplona, Spain
| | - Marta M. Alonso
- Health Research Institute of Navarra (IdiSNA), Pamplona, Spain
- Programs in Solid Tumors and Neuroscience, Foundation for the Applied Medical Research, Pamplona, Spain
- Department of Pediatrics, Clínica Universidad de Navarra, Pamplona, Spain
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