An Atypical Presentation of Sinonasal Tract Alveolar Rhabdomyosarcoma in a Young Male Patient Submitted to Multimodality Treatment

Rhabdomyosarcoma (RMS), a malignant tumor derived from the neoplastic proliferation of striated skeletal muscle cells, is the most common pediatric soft tissue sarcoma. Its treatment is mainly based on neoadjuvant chemotherapy (QT+), surgical resection, and adjuvant radiotherapy (RT+). RT+ has shown...

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Autores principales: Wilber E. Bernaola-Paredes, Sergio Leonardo Favareto, Valdener Bella Filho, Eloah Pascuotte Filippetti, Walkiria Pantoja Bellotto, Henrique Rocha Mazorchi Veronese, Lucas Neves de Martins Moraes, Felipe D’Almeida Costa, Antonio Cassio Assis Pellizzon
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Publicado: Hindawi Limited 2021
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spelling oai:doaj.org-article:6616ecf192e2435093d6ace586c3b2ee2021-11-08T02:36:42ZAn Atypical Presentation of Sinonasal Tract Alveolar Rhabdomyosarcoma in a Young Male Patient Submitted to Multimodality Treatment2090-671410.1155/2021/8401755https://doaj.org/article/6616ecf192e2435093d6ace586c3b2ee2021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/8401755https://doaj.org/toc/2090-6714Rhabdomyosarcoma (RMS), a malignant tumor derived from the neoplastic proliferation of striated skeletal muscle cells, is the most common pediatric soft tissue sarcoma. Its treatment is mainly based on neoadjuvant chemotherapy (QT+), surgical resection, and adjuvant radiotherapy (RT+). RT+ has shown satisfactory results for locoregional control of the disease, in spite of promoting local side effects. The present case report was aimed at describing the clinical and therapeutic characteristics and the management of complications resulting from multimodal therapy in a patient with an atypical presentation of RMS in the sinonasal tract. A 20-year-old Afro-descendant man complained of an expansive tumor lesion, with left eye proptosis that reduced visual acuity and caused severe regional pain. Imaging analysis showed an extensive and infiltrative lesion in the periorbital region, sinonasal tract, left maxilla, and orbital roof. According to the histopathological analysis, the diagnosis was established corresponding to parameningeal alveolar RMS that was unresectable. Treatment was initiated with three cycles of QT+ which showed partial response and later RT+. After completing half of the RT+ sessions, the patient showed a complete response with reduction in tumor volume and improvement in pain and local conditions. Side effects such as alopecia and dermatological changes induced by radiation were observed. Moreover, painful erythematous areas were observed in the region of the hard and soft palate, uvula, and oropharynx, compatible with Grade 2 mucositis lesions. After the cytological swab test, some of them were diagnosed as herpes simplex lesions; thickening and decrease in salivary flow were also found. A local drug therapy approach was instituted, and photobiomodulation was performed to manage oral complications. RT+ was shown to be effective in locoregional control of the disease; however, the early management of its undesirable effects on the surrounding tissues was required.Wilber E. Bernaola-ParedesSergio Leonardo FavaretoValdener Bella FilhoEloah Pascuotte FilippettiWalkiria Pantoja BellottoHenrique Rocha Mazorchi VeroneseLucas Neves de Martins MoraesFelipe D’Almeida CostaAntonio Cassio Assis PellizzonHindawi LimitedarticleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCase Reports in Oncological Medicine, Vol 2021 (2021)
institution DOAJ
collection DOAJ
language EN
topic Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
spellingShingle Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Wilber E. Bernaola-Paredes
Sergio Leonardo Favareto
Valdener Bella Filho
Eloah Pascuotte Filippetti
Walkiria Pantoja Bellotto
Henrique Rocha Mazorchi Veronese
Lucas Neves de Martins Moraes
Felipe D’Almeida Costa
Antonio Cassio Assis Pellizzon
An Atypical Presentation of Sinonasal Tract Alveolar Rhabdomyosarcoma in a Young Male Patient Submitted to Multimodality Treatment
description Rhabdomyosarcoma (RMS), a malignant tumor derived from the neoplastic proliferation of striated skeletal muscle cells, is the most common pediatric soft tissue sarcoma. Its treatment is mainly based on neoadjuvant chemotherapy (QT+), surgical resection, and adjuvant radiotherapy (RT+). RT+ has shown satisfactory results for locoregional control of the disease, in spite of promoting local side effects. The present case report was aimed at describing the clinical and therapeutic characteristics and the management of complications resulting from multimodal therapy in a patient with an atypical presentation of RMS in the sinonasal tract. A 20-year-old Afro-descendant man complained of an expansive tumor lesion, with left eye proptosis that reduced visual acuity and caused severe regional pain. Imaging analysis showed an extensive and infiltrative lesion in the periorbital region, sinonasal tract, left maxilla, and orbital roof. According to the histopathological analysis, the diagnosis was established corresponding to parameningeal alveolar RMS that was unresectable. Treatment was initiated with three cycles of QT+ which showed partial response and later RT+. After completing half of the RT+ sessions, the patient showed a complete response with reduction in tumor volume and improvement in pain and local conditions. Side effects such as alopecia and dermatological changes induced by radiation were observed. Moreover, painful erythematous areas were observed in the region of the hard and soft palate, uvula, and oropharynx, compatible with Grade 2 mucositis lesions. After the cytological swab test, some of them were diagnosed as herpes simplex lesions; thickening and decrease in salivary flow were also found. A local drug therapy approach was instituted, and photobiomodulation was performed to manage oral complications. RT+ was shown to be effective in locoregional control of the disease; however, the early management of its undesirable effects on the surrounding tissues was required.
format article
author Wilber E. Bernaola-Paredes
Sergio Leonardo Favareto
Valdener Bella Filho
Eloah Pascuotte Filippetti
Walkiria Pantoja Bellotto
Henrique Rocha Mazorchi Veronese
Lucas Neves de Martins Moraes
Felipe D’Almeida Costa
Antonio Cassio Assis Pellizzon
author_facet Wilber E. Bernaola-Paredes
Sergio Leonardo Favareto
Valdener Bella Filho
Eloah Pascuotte Filippetti
Walkiria Pantoja Bellotto
Henrique Rocha Mazorchi Veronese
Lucas Neves de Martins Moraes
Felipe D’Almeida Costa
Antonio Cassio Assis Pellizzon
author_sort Wilber E. Bernaola-Paredes
title An Atypical Presentation of Sinonasal Tract Alveolar Rhabdomyosarcoma in a Young Male Patient Submitted to Multimodality Treatment
title_short An Atypical Presentation of Sinonasal Tract Alveolar Rhabdomyosarcoma in a Young Male Patient Submitted to Multimodality Treatment
title_full An Atypical Presentation of Sinonasal Tract Alveolar Rhabdomyosarcoma in a Young Male Patient Submitted to Multimodality Treatment
title_fullStr An Atypical Presentation of Sinonasal Tract Alveolar Rhabdomyosarcoma in a Young Male Patient Submitted to Multimodality Treatment
title_full_unstemmed An Atypical Presentation of Sinonasal Tract Alveolar Rhabdomyosarcoma in a Young Male Patient Submitted to Multimodality Treatment
title_sort atypical presentation of sinonasal tract alveolar rhabdomyosarcoma in a young male patient submitted to multimodality treatment
publisher Hindawi Limited
publishDate 2021
url https://doaj.org/article/6616ecf192e2435093d6ace586c3b2ee
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