Rhabdomyosarcoma Of Prostate Research Articles

ANTERIOR SAGITTAL TRANSANORECTAL APPROACH TO THE POSTERIOR URETHRA IN THE PEDIATRIC AGE GROUP

Purpose Surgical access to the posterior urethra is often difficult and several surgical solutions have been proposed. We suggest an anterior sagittal transanorectal approach based on splitting the anterior rectal wall only. This alternative technique provides excellent exposure to the retrourethral region, permitting simple and safe surgery. Materials and Methods Between 1994 and 1996 we performed surgery via the anterior sagittal transanorectal approach in 8 patients with a mean age of 9.06 years. Patients included 1 girl with a posttraumatic urethrovaginal fistula, 3 with intersex disorders (2 with mixed gonadal dysgenesis raised as boys and 1 with male dysgenetic pseudohermaphroditism with an enlarged urtricle) and 4 boys (1 with penile agenesis raised as girl, 2 with urethral duplication and 1 with prostatic rhabdomyosarcoma). The patient was placed in a knee-chest position. A midline sagittal incision was made through the anterior anorectal wall only and deepened through the perineal body to expose the posterior urethra and retrovesical space. After the pathological condition was corrected the anterior rectal wall and perineal body were reconstructed. The operation was completed with protective colostomy. In our final patient with prostatic rhabdomyosarcoma the anterior sagittal transanorectal approach was used without colostomy. Anorectal manometry was done 6 months postoperatively. Results All patients were completely continent of stool and urine. Convalescence was unremarkable in all cases. Postoperative manometry in 7 patients revealed no differences from preoperative measurements. Conclusions This procedure should be considered a useful alternative to other techniques for various congenital and acquired pelvic disorders.

Metastatic rhabdomyosarcoma presenting as intracranial hemorrhage: imaging findings

The CNS is rarely the first site of metastasis for rhabdomyosarcoma. CNS involvement is uncommon, and usually seen as leptomeningeal spread after development of pulmonary metastases. We present the imaging findings in a 13-year-old boy in whom a large intracranial hemorrhage was the initial presentation of surgically documented metastatic prostatic rhabdomyosarcoma. Multiple chest CTs and radionuclide bone scans had previously shown no evidence of pulmonary or osseous metastases. The significance of this case in relation to the possible role of the need for use of chemotherapeutic agents that cross the blood-brain barriers to prevent brain metastasis is discussed.

The argument for conservative, delayed surgery in the management of prostatic rhabdomyosarcoma

Exenteration is no longer required for most patients who have rhabdomyosarcoma (RMS) of the prostate. This site comprised only about 5% of newly diagnosed cases in the IRS-III (1984–1991). The mean age at the time of diagnosis was 5.3 yrs (range, 0 to 19 years). Most tumors were relatively large, had embryonal histology, and were clinically localized but unresectable without major loss of organ function. The 44 patients with group III tumors (gross residual disease) were treated according to the IRS-III protocol. Forty-three of them underwent biopsy only, and one patient had subtotal resection as the initial procedure. The average number of surgical procedures per patient was two (range, one to five). Six of the 44 patients had no additional surgery. The second-look procedures performed in the other 38 patients included exenteration (14), prostatectomy (7), cystoscopic/perineal needle biopsy (8), laparotomy with biopsy (6), and subtotal excision with bladder salvage (3). Additional surgery was required for four patients, for evaluation of a residual mass, postoperative fistula, ureteral stricture, or small bowel obstruction. Six patients with relapse or residual disease underwent additional chemotherapy and late exenteration (3), prostatectomy (1), or biopsy (2). Four of the six have been cured, one is in treatment for a second malignancy, and the other has residual disease after exenteration. Thirty-six of the 44 patients with group III tumors have been cured (minimum follow-up period, 6 years; range, 6 to 11 years), compared with 23 of the 47 in IRS-II (1978–1984) (P = .001). Two of the six deaths in this group were caused by infection. The bladder salvage rate for those cured of their disease also was better (64% v 57% for IRS-II). The two patients with group IIA tumors were cured by gross primary excision, local radiotherapy, and vincristine and actinomycin therapy. By contrast, all patients with metastatic disease (group IV) died of the tumor. Conservative, delayed surgery, performed after intensive chemotherapy with or without radiotherapy, yields a better cure rate while maintaining a high rate of bladder salvage in children with group III prostatic RMS.

Surgery in rhabdomyosarcoma of the bladder, prostate and vagina.

The treatment of bladder and prostate rhabdomyosarcoma (RMS) is highly controversial. Aside from chemotherapy, treatment modalities include conservative surgery, radical surgery, and pre-, intra-, or postoperative irradiation. Between 1968 and 1993, 78 children with RMS were treated at our institution. In all, 22 tumors were located in the urogenital tract (bladder/prostate, 13; paratesticular, 5; vaginal, 2; others, 2). Altogether, 6 patients had stage II disease; 7, stage III disease; and 2, stage IV disease. All 15 patients with RMS of the bladder, prostate, or vagina received chemotherapy, and 4 had additional radiotherapy. Surgery was also done in 10 patients; parents refused an operation in 3 cases. In all, 3 patients in an advanced tumor stage died of their disease. All other children currently show no evidence of disease (mean follow-up, 6 years; range, from 2 months to 18 years). After chemotherapy, radical operative intervention with multiple biopsies (encircling the tumor)--in contrast to local tumor excision or partial resection--permits complete tumor resection followed by excellent long-term results. Following radiotherapy, often a consequence of organ-sparing therapy, many complications ensued (60%); therefore, irradiation should be restricted to highly selected cases.

Transrectal ultrasound in the evaluation of rhabdomyosarcoma involving the prostate

To evaluate transrectal ultrasound as a means of diagnosis and of monitoring patients with rhabdomyosarcoma involving the prostate. Serial transrectal ultrasonography was utilized to evaluate prostatic rhabdomyosarcoma in three patients. Unlike prostatic adenocarcinoma and transitional cell carcinoma involving the prostate, which are predominantly hypoechoic, the echogenicity of rhabdomyosarcoma is similar to that of the normal prostate. Transrectal ultrasound provided a simple means of monitoring prostate size and sampling tissue in these patients. Transrectal ultrasound imaging can be useful in both diagnosis and evaluation of treatment response as well as provide easy access for biopsies in patients with rhabdomyosarcoma involving the prostate.

Conservative surgery of bladder-prostate rhabdomyosarcoma in children: Results after long-term follow-up

Between 1968 and 1982, 10 children (7 boys and 3 girls) with a mean age of 3.2 years affected by bladder (8 cases) and prostate (2 cases) rhabdomyosarcoma (RMS)—all histologically embryonal—were seen. Three (1 with bone metastases at diagnosis and 2 with stage III tumor) underwent radical surgery; all died because of progression of the disease. Seven children were treated with conservative surgery: 3 solid type bladder tumors were removed together with a narrow strip of apparently healthy bladder wall, sparing 30% to 70% of the bladder; 3 botryoid type bladder tumors were removed bluntly and implantation sites fulgurated; in 1 prostate tumor osmotic cytolysis of the neoplastic mass was achieved with multiple injections of hypertonic saline solution (NaCl 30%). Surgery was followed by chemotherapy with a vincristine actinomycin D and cyclophosphamide protocol and radiotherapy (20 to 39.5 Gy). Six of the seven are alive and disease free with a normal functional bladder after 10 to 21 years. The validity of a primary conservative surgical approach with preservation of the bladder, followed by adjuvant therapy, is emphasized.

Sarcomas in three generations of a family with neurofibromatosis

The development of sarcomas in three generations of a family with neurofibromatosis (NF) is described. A 7-month-old boy developed a prostatic rhabdomyosarcoma. Family history revealed that his maternal grandmother had died of a malignant peripheral nerve sheath tumor at age 37 years and had been affected with neurofibromatosis. His mother (aged 36 years) has also developed a malignant peripheral nerve sheath tumor and NF has been confirmed in both mother and son. This family illustrates a cluster of sarcomas associated with NF and shows the importance of thorough investigation of reported family illnesses.

Rhabdomyosarcoma of the prostate in childhood: current challenges.

Since 1978, six boys with prostatic rhabdomyosarcoma have been treated at our institution. Three had localized disease and were managed by initial biopsy, vincristine, actinomycin-D, and cyclophosphamide (VAC) chemotherapy, and bladder-sparing surgery with or without irradiation. Further combination chemotherapy ("pulse" VAC, Adriamycin, VP-16, cisplatin, and ifosfamide) was continued for 20 to 22 months following the induction course. Two boys had microscopic residual disease undetected by frozen section and unresponsive to radiotherapy. Subsequent total cystectomy 4 and 7 months later resulted in eradication of disease. In one patient, preservation of the bladder was achieved at the age of 3 months for 8 years. Artificial sphincter inserted to cure his urinary incontinence failed because of ischemia secondary to cuff compression and scar tissue. He is alive today with a modified Koch pouch urinary diversion. Of the 50% who had metastatic disease at presentation, two were dead within 12 months despite aggressive chemotherapy and irradiation. The third is currently on treatment. Although chemotherapy has markedly improved the prognosis, surgery is still necessary in most cases for cure. Bladder salvage is a desirable goal; however, residual microscopic disease, difficulty with frozen-section disease detection, and poor tissue vascularization for subsequent sphincter replacement remain significant obstacles.

Extent of surgery in rhabdomyosarcoma of urogenital structures.

After high inguinal semicastration in group-1 paratesticular rhabdomyosarcoma (RMS), the patient having undergone chemotherapy can be followed closely by CT scanning without retroperitoneal lymphadenectomy. In contrast, retroperitoneal RMS should be operated on as radically as possible after downstaging the tumor mass. In RMS of the female genitalia locally limited organ-preserving surgery is the method of choice. The prognosis is excellent with adjuvant chemotherapy. Only 20% of all bladder RMS arise from the bladder dome or the movable part of the bladder, where primary partial resection including a safety margin of 3 cm of healthy tissue is possible. The majority, however, arising from the submucous tissue of the bladder base, trigonal area and bladder neck, infiltrates the prostatic urethra and the surrounding pelvic fascia. Therefore differentiation between primary bladder or prostate RMS is often doubtful. The current strategy of downstaging by chemotherapy or chemo-radiotherapy followed either by limited organ-preserving surgery or by a wait-and-see policy includes the high risk of residual tumor or local tumor recurrence, which has proved to have the worst prognosis of all. As organ-preserving therapy was recommended as the method of choice, mainly to avoid anterior pelvic exenteration and urinary diversion, the question of advantages in comparison to the risk of tumor recurrence is still open. The routine use of chemoradiotherapy and increasing follow-up has called attention to a variety of chronic sequelae, such as contracted bladders with reduced capacity and upper urinary tract deterioration, which subsequently require secondary urinary diversion. Progress in continent urinary diversion may be an alternative procedure for better life quality.(ABSTRACT TRUNCATED AT 250 WORDS)

Embryonal Rhabdomyosarcoma of Bladder and Prostate: Nuclear DNA Patterns Studied by Flow Cytometry

Nuclear deoxyribonucleic acid ploidy studies with paraffin-embedded archival tumor specimens were performed by flow cytometry on extracted nuclei from 13 embryonal rhabdomyosarcomas of the bladder and prostate. Preparation of embedded tissue specimens into single dissociated nuclei was by the Hedley technique and they were stained with propidium iodide according to the Vindel0v method. Before the era of chemotherapy, 6 of 7 patients died of disease at a median of 5.5 months post-treatment. All 6 deaths occurred in patients with deoxyribonucleic acid aneuploid patterns that were stage II or greater. The 1 survivor had a deoxyribonucleic acid aneuploid pattern and stage I disease and is alive at 12 years of followup. Since 1971, 6 patients were treated with primary polychemotherapy and surgery. All 6 patients are alive without evidence of disease at a mean followup of 75 months (range 12 to 180 months). All 6 patients had deoxyribonucleic acid aneuploid tumors. One patient was stage I and 5 patients were stage III. Thus, all patients with pediatric embryonal rhabdomyosaroma of the bladder and prostate had deoxyribonucleic acid aneuploid tumors. These patients responded well to treatment with the combination of chemotherapy and surgery. (J. Urol, part 2, 140:1119-1121, 1988)

Role of gallium-67 in management of paediatric solid tumours.

. Gallium-67 citrate (Ga67) has been advocated for the evaluation of cancer in infants and children. Its role in patient management is not well defined. Over a 2-year period, 136 Ga67 whole body scans were performed on 79 infants and children with cancer. Abnormal scans were found in 39 children with solid tumours before the commencement of therapy. Nineteen children on therapy at the time of the scan had normal studies and were clinically disease free. Seventeen children showed Ga67 avid recurrence of disease after treatment. Four of 5 children with leukaemia who had scans for the detection of infection showed an inflammatory focus on scan and directed appropriate management. Two children with a prostatic rhabdomyosarcoma did not accumulate gallium in the primary tumour before treatment. Whole body Ga67 scans should be performed prior to treatment in all children with solid tumours. If the tumour is Ga67 avid then serial scans are indicated to assess response to therapy, to detect recurrence and/or infective complications of the disease.

Rhabdomyosarcoma of prostate in adult: Long-term survival and problem of histologic diagnosis

Only 1 case of primary rhabdomyosarcoma of the prostate in an adult with a five-year survival has been described previously. Reported here is a case of a recurrent lesion initially diagnosed as a fibroepithelial polyp and then later recognized to be rhabdomyosarcoma. Radical surgery was not performed, yet the patient survived seven years before dying of generalized metastatic rhabdomyosarcoma. This course represents a unique pathobiology for primary rhabdomyosarcoma of the prostate. It also demonstrates a histologic continuum between fibroepithelial polyp and rhabdomyosarcoma in which the pathognomonic features of the sarcoma were not recognized until two years after the initial biopsy. This argues for an increased index of suspicion for sarcoma of the prostate in a young person with a prostatic nodule even in the face of a benign-looking initial biopsy.

Seven-year survival of child with rhabdomyosarcoma of prostate

A case is reported of a twenty-two-month-old child who has survived for seven years without recurrence after multimodal therapy of a rhabdomyosarcoma of the prostate. The patient was treated with preoperative irradiation, radical surgery, and intraoperative and postoperative actinomycin D.

Rhabdomyosarcoma in adult prostate

A case of rhabdomyosarcoma of the adult prostate is reported. Metastatic disease in both lung fields was treated by triple-drug therapy. This regimen has been maintained to date with resolution of pulmonary nodules.

Sarcoma de próstata: presentación de un caso y revisión de la literatura

Descripción: Él caso es un paciente de 18 años de edad que acudió por hematuria y retención aguda de orina. Fue diagnosticado por cistoscopia y resección transuretral de próstata (rtup); rabdomiosarcoma de próstata.
 Relevancia: Muy pocos casos reportados en el país y en la literatura mundial, que hacen difícil la sospecha diagnóstica, y una vez que se tiene formulan un reto terapéutico y multidisciplinario.
 Implicaciones clínicas: Hematuria y crecimiento prostático obstructivo, en pacientes menores de la cuarta década de la vida son los rasgos que deben llamar el interés para la sospecha de este tipo de neoplasia.
 Conclusiones: Los sarcomas de próstata son tumores poco frecuentes, lo cual dificulta el conocimiento de su historia natural. La progresión local y a distancia es muy rápida, con una supervivencia media de 2 años, a pesar del manejo terapéutico multimodal. El principal factor de supervivencia es una resección completa del tumor, un estadio local poco avanzado y grado tumoral. Es necesario buscar nuevos protocolos quimioterápicos que permitan prolongar la supervivencia de estos pacientes como se ha demostrado en otro tipo de sarcomas de extremidades.

Rhabdomyosarcoma of the Prostate

Rhabdomyosarcoma of the Prostate

Rhabdomyosarcoma of Prostate with Extensive Central Nervous System Metastases: A Case Report

Rhabdomyosarcoma of Prostate with Extensive Central Nervous System Metastases: A Case Report

Rhabdomyosarcoma of the Spermatic Cord

No AccessJournal of Urology1 Sep 1955Rhabdomyosarcoma of the Spermatic Cord Cary P. Gray, and Carl L. Biorn Cary P. GrayCary P. Gray More articles by this author , and Carl L. BiornCarl L. Biorn More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)67297-5AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1955 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited BySclama A, Berger B, Cherry J and Young J (2018) Malignant Fibrous Histiocytoma of the Spermatic Cord: The Role of Retroperitoneal Lymphadenectomy in ManagementJournal of Urology, VOL. 130, NO. 3, (577-579), Online publication date: 1-Sep-1983.Malek R (2018) Editorial CommentJournal of Urology, VOL. 130, NO. 3, (579-579), Online publication date: 1-Sep-1983.Banik S and Guha P (2018) Paratesticular Rhabdomyosarcomas and Leiomyosarcomas: A Clinicopathological ReviewJournal of Urology, VOL. 121, NO. 6, (823-826), Online publication date: 1-Jun-1979.Bissada N, Finkbeiner A and Redman J (2018) Paratesticular Sarcomas: Review of ManagementJournal of Urology, VOL. 116, NO. 2, (198-200), Online publication date: 1-Aug-1976.Skeel D, Drinker H and Witherington R (2018) Rhabdomyosarcoma of the Spermatic Cord: Report of 3 Cases with Review of the LiteratureJournal of Urology, VOL. 113, NO. 2, (279-284), Online publication date: 1-Feb-1975.Banowsky L and Shultz G (2018) Sarcoma of the Spermatic Cord and Tunics: Review of the Literature, Case Report and Discussion of the Role of Retroperitoneal Lymph Node DissectionJournal of Urology, VOL. 103, NO. 5, (628-631), Online publication date: 1-May-1970.Rayich L, Lerman P and Sands A (2018) Intrascrotal Extratesticular RhabdomyosarcomaJournal of Urology, VOL. 92, NO. 2, (144-147), Online publication date: 1-Aug-1964.Gray C and Biorn C (2018) Myosarcoma of the Spermatic CordJournal of Urology, VOL. 84, NO. 4, (562-564), Online publication date: 1-Oct-1960.Dreyfuss W and Goodsitt E (2018) Tumors of the Spermatic CordJournal of Urology, VOL. 84, NO. 5, (658-665), Online publication date: 1-Nov-1960.Johnson W (2018) Rhabdomyosarcoma of Prostate with Extensive Central Nervous System Metastases: A Case ReportJournal of Urology, VOL. 84, NO. 6, (758-760), Online publication date: 1-Dec-1960.Satter E, Heidner F and Wear J (2018) Primary Sarcoma of the Spermatic Cord and EpididymisJournal of Urology, VOL. 82, NO. 1, (148-154), Online publication date: 1-Jul-1959. Volume 74Issue 3September 1955Page: 402-406 Advertisement Copyright & Permissions© 1955 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Cary P. Gray More articles by this author Carl L. Biorn More articles by this author Expand All Advertisement PDF DownloadLoading ...

Rhabdomyosarcoma of the Prostate

Rhabdomyosarcoma of the Prostate

Rhabdomyosarcoma of the Urinary Bladder: A Clinico-Pathological Case Report with a Review of the Literature, Including a Tabulation of Rhabdomyosarcoma of Prostate

No AccessJournal of Urology1 May 1944Rhabdomyosarcoma of the Urinary Bladder: A Clinico-Pathological Case Report with a Review of the Literature, Including a Tabulation of Rhabdomyosarcoma of Prostate1 Ernest N. Khoury and Francis D. Speer Ernest N. KhouryErnest N. Khoury More articles by this author and Francis D. SpeerFrancis D. Speer More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)70386-2AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1944 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byNarayana A, Loening S, Weimar G and Culp D (2018) Sarcoma of the Bladder and ProstateJournal of Urology, VOL. 119, NO. 1, (72-76), Online publication date: 1-Jan-1978.Evans A and Bell T (2018) Rhabdomyosarcoma of the Bladder in Adult Patients: Report of Three CasesJournal of Urology, VOL. 94, NO. 5, (573-575), Online publication date: 1-Nov-1965.Kost L and Evans G (2018) Occurrence and Significance of Striated Muscle within the ProstateJournal of Urology, VOL. 92, NO. 6, (703-704), Online publication date: 1-Dec-1964.Jones C and Oberman H (2018) Rhabdomyosarcoma of the Bladder: Occurrence in Childhood and in Advanced AgeJournal of Urology, VOL. 91, NO. 5, (533-537), Online publication date: 1-May-1964.Bhansali S (2018) Sarcoma Botryoides of the Bladder in Infancy and ChildhoodJournal of Urology, VOL. 87, NO. 6, (871-875), Online publication date: 1-Jun-1962.Johnson W (2018) Rhabdomyosarcoma of Prostate with Extensive Central Nervous System Metastases: A Case ReportJournal of Urology, VOL. 84, NO. 6, (758-760), Online publication date: 1-Dec-1960.Thompson I and Coppridge A (2018) The Management of Bladder Tumors in Children: A Study of Sarcoma BotryoidesJournal of Urology, VOL. 82, NO. 5, (590-595), Online publication date: 1-Nov-1959.Russell M, Lipin J and Gaines J (2018) Tumors of the Bladder in Infants: A Case Report of A Benign Tumor And A Review of the LiteratureJournal of Urology, VOL. 79, NO. 5, (823-827), Online publication date: 1-May-1958.Silbar J and Silbar S (2018) Leiomyosarcoma of Bladder: Three Case Reports and a Review of LiteratureJournal of Urology, VOL. 73, NO. 1, (103-111), Online publication date: 1-Jan-1955.Flocks E and Culp D (2018) Polypoid Fibromyxosarcoma of the Urinary Bladder in a ChildJournal of Urology, VOL. 73, NO. 2, (299-306), Online publication date: 1-Feb-1955.Riddell H and Kudish H (2018) Rhabdomyosarcoma of the Bladder: Review and Report of a CaseJournal of Urology, VOL. 70, NO. 3, (472-476), Online publication date: 1-Sep-1953.Grier E and Phillips F (2018) Rhabdomyosarcoma of the ProstateJournal of Urology, VOL. 69, NO. 5, (695-702), Online publication date: 1-May-1953.Mostofi F and Morse W (2018) Polypoid Rhabdomyosarcoma (Sarcoma Botryoides) of Bladder in ChildrenJournal of Urology, VOL. 67, NO. 5, (681-687), Online publication date: 1-May-1952.Youngblood V, Banks R and Denney E (2018) Rhabdomyosarcoma of the BladderJournal of Urology, VOL. 67, NO. 6, (957-961), Online publication date: 1-Jun-1952.Fister G and Lund A (2018) Myosarcoma of the BladderJournal of Urology, VOL. 65, NO. 3, (401-407), Online publication date: 1-Mar-1951.Laughlin V, Althoff C and Brown H (2018) Polymorphous Cell Sarcoma of the Bladder: Case ReportJournal of Urology, VOL. 60, NO. 3, (459-462), Online publication date: 1-Sep-1948.Luhr A (2018) Primary Spindle Cell Sarcoma of the Urinary Bladder With Solitary Metastasis to the Heart Muscle: Case ReportJournal of Urology, VOL. 56, NO. 1, (78-80), Online publication date: 1-Jul-1946. Volume 51Issue 5May 1944Page: 505-516 Advertisement Copyright & Permissions© 1944 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Ernest N. Khoury More articles by this author Francis D. Speer More articles by this author Expand All Advertisement PDF downloadLoading ...