Markov Stoyan Stefanov, Spasova Mariya Ivanova, Spasov Neofit Iuriev, Markova Petya Petkova
Department of Otorhinolaryngology, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria.
Department of Otorhinolaryngology, University Hospital "St. George", 4000 Plovdiv, Bulgaria.
Children (Basel). 2024 Dec 8;11(12):1496. doi: 10.3390/children11121496.
Rhabdomyosarcoma (RMS) is a highly malignant soft tissue tumor derived from primitive embryonal mesenchymal tissue that differentiates into striated skeletal muscle. Despite the improved outcome based on the EFS and OS using the three different treatment modalities-chemotherapy, radiotherapy and surgical treatment, the survival of patients depends on their IRS groups-pathological and surgical. On the other hand in the last thirty years a great improvement of the five-year overall survival (OS) of children with RMS have been observed based on the results of large multinational collaborative trials and successive studies dedicated to children, though prognosis is variable and dependent on several factors including histologic variant, primary sites of the tumor, extent of disease (disease resectability), and molecular-level characteristics.
We present a clinical case of a five-year-old male with initial complains of left side peripheral facial nerve palsy and secondary cervical and retroauricular lymphadenomegaly. After an exam, surgery of the temporal bone, CT and MRI embryonal type of rhabdomyosarcoma was diagnosed, and adjuvant chemotherapy was initiated in combination with concomitant local radiotherapy.
The results show that in these areas surgery itself is insufficient for RMS treatment(usually it is limited to taking a biopsy only). The combination of chemotherapy and local control with radiotherapy achieved a good result in our patient.
Middle ear Embryonal Rhabdomyosarcoma is a common solid tumor, which could mimic middle ear inflammation or mastoid inflammation in patients. The multimodal approach seemed to be the ideal management of RMS. It involves a combination of chemotherapy and local control with surgery and/or radiotherapy.
横纹肌肉瘤(RMS)是一种高度恶性的软组织肿瘤,起源于可分化为横纹骨骼肌的原始胚胎间充质组织。尽管采用化疗、放疗和手术这三种不同治疗方式,基于无事件生存期(EFS)和总生存期(OS)的治疗结果有所改善,但患者的生存情况仍取决于其国际横纹肌肉瘤研究组(IRS)分组——病理和手术情况。另一方面,在过去三十年中,基于大型跨国协作试验以及针对儿童的后续研究结果,观察到RMS患儿的五年总生存期(OS)有了显著改善,不过预后存在差异,且取决于多种因素,包括组织学变异、肿瘤的原发部位、疾病范围(疾病可切除性)以及分子水平特征。
我们报告一例临床病例,患者为一名五岁男性,最初主诉左侧周围性面神经麻痹以及继发性颈部和耳后淋巴结肿大。经过检查、颞骨手术、CT和MRI检查,诊断为胚胎型横纹肌肉瘤,并开始辅助化疗,同时进行局部放疗。
结果表明,在这些部位,单纯手术不足以治疗RMS(通常仅局限于进行活检)。化疗与放疗相结合的局部控制方法在我们的患者中取得了良好效果。
中耳胚胎型横纹肌肉瘤是一种常见的实体瘤,在患者中可能表现为中耳炎症或乳突炎。多模式治疗方法似乎是RMS的理想治疗方案。它包括化疗与手术和/或放疗相结合的局部控制。