Published online Dec 16, 2017. doi: 10.12998/wjcc.v5.i12.440
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
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.
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.