Successful Treatment of Adult Pleomorphic Rhabdomyosarcoma in the Posterior Left Femur: A Case Report

Abstract

Introduction: Rhabdomyosarcoma (RMS) is the most common childhood soft tissue sarcoma, but it represents only a small portion of soft tissue sarcoma in adult population. There is a treatment protocol based on Intergroup Rhabdomyosarcoma Study (IRS) that provides satisfactory results in treating RMS in children, but there is only limited evidence regarding the outcome and prognosis in extrapolating the IRS protocol to treat RMS in adults. We report a case of adult pleomorphic RMS treated with multidisciplinary approach and the results we have obtained. Case presentation: A 48-year-old woman was admitted in February 2011 due to a painful mass on her left thigh. Diagnosis of pleomorphic rhabdomyosarcoma was made by histopathology and immunohistochemistry. After multimodal treatment that includes Trans-Arterial Chemotherapy Infusion, Cryosurgery, and wide excision surgery, our patient remains disease-free as of the latest annual follow up examination on June 2017. Conclusions: The pleomorphic type of Rhabdomyosarcoma is very rare in adults and is often associated with a poor prognosis. In our case, a multidisciplinary approach with multimodal treatment provides excellent result, even after a routine follow up spanning through six years.

Adult Pleomorphic Rhabdomyosarcoma of the Peroneal Compartment; Rare Case Report

“…In a recent case report of a 48 year old female with pleomorphic RMS with a 6 year follow up the use of transcatheter intraarterial therapy involving high concentration delivery of chemotherapeutic drugs directly to the tumour and cryosurgery has given a very favorable outcome with limb preservation [4] . Several sessions of cryosurgery were done at -160 to -180 o C prior and after total surgical resection.…”

“…Several sessions of cryosurgery were done at -160 to -180 o C prior and after total surgical resection. That patient has been followed up for 6 years with no evidence of recurrence [4] . This is a viable option that may become routine in the future.…”

“…The pleomorphic form is typically more frequent in adults and has a poor prognosis [1,2] . RMSs are solid tumors that are common in children, representing 5% of all childhood cancers [1,2,3,4] . In contrast, RMSs are rare in adults, with soft-tissue sarcomas making up fewer than 1% of malignancies in adults and RMSs accounting for 3% of all soft tissue sarcomas [1] .…”