Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2017; 5(12): 440-445
Published online Dec 16, 2017. doi: 10.12998/wjcc.v5.i12.440
Embryonal rhabdomyosarcoma in the maxillary sinus with orbital involvement in a pediatric patient: Case report
Ana Carolina Rodrigues de Melo, Tácio Candeia Lyra, Isabella Lima Arrais Ribeiro, Alexandre Rolim da Paz, Paulo Rogério Ferreti Bonan, Ricardo Dias de Castro, Ana Maria Gondim Valença
Ana Carolina Rodrigues de Melo, Tácio Candeia Lyra, Isabella Lima Arrais Ribeiro, Ricardo Dias de Castro, Ana Maria Gondim Valença, Department of Clinical and Social Dentistry, Federal University of Paraíba, João Pessoa 58051-900, Brazil
Alexandre Rolim da Paz, Department of Pathology, Hospital Napoleão Laureano, João Pessoa 58015-170, Brazil
Paulo Rogério Ferreti Bonan, Department of Restorative Dentistry, Federal University of Paraíba, João Pessoa 58051-900, Brazil
Author contributions: Valença AMG, Bonan PRF and de Castro RD designed the report; da Paz AR performed the histopathological and immunohistochemical analyses; de Melo ACR and Ribeiro ILA collected the patient’s clinical data; de Melo ACR, Lyra TC and Ribeiro ILA wrote the paper.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at University Federal of Paraíba.
Informed consent statement: Patient was informed about the publication.
Conflict-of-interest statement: We, the authors of this paper “Embryonal rhabdomyosarcoma in the maxillary sinus with orbital involvement in a pediatric patient: Case report”, stating that we participate sufficiently in the design of the study and development of this work and we take public responsibility on it and we delegate to the World Journal of Clinical Cases the copyright upon acceptance of the publication of this. The authors undersigned declare no conflict of interest regarding this manuscript, as well as the information it contains.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ricardo Dias de Castro, Adjunct Professor, Department of Clinical and Social Dentistry, Federal University of Paraíba, Av. Cidade Universitária, s/n - Castelo Branco III, João Pessoa 58051-900, Brazil. rcastro@ccs.ufpb.br
Telephone: +55-83-32167200
Received: July 10, 2017
Peer-review started: July 20, 2017
First decision: September 4, 2017
Revised: September 29, 2017
Accepted: October 29, 2017
Article in press: October 29, 2017
Published online: December 16, 2017
Abstract

This report presents a case of embryonal rhabdomyosarcoma (eRMS) located in the left maxillary sinus and invading the orbital cavity in a ten-year-old male patient who was treated at a referral hospital. The images provided from the computed tomography showed a heterogeneous mass with soft-tissue density, occupying part of the left half of the face inside the maxillary sinus, and infiltrating and destroying the bone structure of the maxillary sinus, left orbit, ethmoidal cells, nasal cavity, and sphenoid sinus. An analysis of the histological sections revealed an undifferentiated malignant neoplasm infiltrating the skeletal muscle tissue. The immunohistochemical analysis was positive for the antigens: MyoD1, myogenin, desmin, and Ki67 (100% positivity in neoplastic cells), allowing the identification of the tumour as an eRMS. The treatment protocol included initial chemotherapy followed by radiotherapy and finally surgery. The total time of the treatment was nine months, and in 18-mo of follow-up period did not show no local recurrences and a lack of visual impairment.

Keywords: Oncology, Embryonal rhabdomyosarcoma, Pediatrics, Maxillary sinus, Chemotherapy

Core tip: This case report is important because it describes the diagnosis trajectory of a rhabdomyosarcoma located in an uncommon region, presenting the steps of the exams performed and their results. The knowledge must be realized with the intention of improving the diagnosis and the clinical conduct, giving greater survival rate and better quality of life to the patient. The early diagnosis was very important in this case, due to the imaging and histopathological exams in question with the association of experienced pathologists.