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

Barlian Sutedja,Tjondro Setiawan,Abdul Muthalib,Terawan Agus Putranto,Diah Rini Handjari,Ikhwan Rinaldi,Jubilate Edward I Tambun ,Reza Adiwidjaja

doi:10.4236/ijcm.2018.94027

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.

Highlights

IntroductionRhabdomyosarcoma (RMS) is the most common childhood soft tissue sarcoma, accounting for more than 50% of all soft tissue sarcomas
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

Summary

Introduction

Rhabdomyosarcoma (RMS) is the most common childhood soft tissue sarcoma, accounting for more than 50% of all soft tissue sarcomas. The pleomorphic type RMS is signified by the lack of embryonal or alveolar features in histologic examinations. This type of RMS tends to affect adults, with peak incidence in the fifth decade of life. The Intergroup Rhabdomyosarcoma Study (IRS) was made in 1972 to better understand and improve treatment modalities for children with RMS The result of this joint effort is better staging and risk stratification, local therapy, and supportive care [3]. One case of adult Embryonal RMS in Indonesia reported in 2015 was successfully cured through surgical amputation [7] While it may be considered a success, the loss of a limb would adversely affect the quality of life of the patient

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