Management of pediatric head and neck rhabdomyosarcoma: A case-series of 36 patients

Radzikowska,Joanna; Kukwa,Wojciech; Kukwa,Andrzej; Czarnecka,Anna   M.; Kawecki,Maciej; Lian,Fei; Szczylik,Cezary; Krzeski,Antoni

doi:10.3892/ol.2016.5072

Management of pediatric head and neck rhabdomyosarcoma: A case-series of 36 patients

Authors:
- Joanna Radzikowska
- Wojciech Kukwa
- Andrzej Kukwa
- Anna M. Czarnecka
- Maciej Kawecki
- Fei Lian
- Cezary Szczylik
- Antoni Krzeski
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Affiliations: Department of Otorhinolaryngology, Faculty of Medicine and Dentistry, Medical University of Warsaw, Warsaw 00‑739, Poland, Department of Otolaryngology and Head and Neck Disease, University of Varmia and Mazury, Olsztyn 10‑082, Poland, Department of Oncology and Molecular Oncology Laboratory, Military Institute of Medicine,Warsaw 04‑141, Poland, Department of Urology, Emory University School of Medicine, Atlanta, GA 30322, USA
Published online on: September 1, 2016 https://doi.org/10.3892/ol.2016.5072
Pages: 3555-3562

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Abstract

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in the pediatric population. In 35% of cases, RMS develops in the head and neck (H&N) region, and only combined therapy is recognized as a curative treatment. However, recent advances in skull base and reconstructive surgery, along with microsurgery and endoscopic surgery, have strengthened the role of surgery as an important part of RMS treatment. In the present study, 36 pediatric RMS cases (24 males and 12 females) were analyzed after surgical treatment. The average age at diagnosis was 7 years. In total, 67% of tumors were localized in the parameningeal region. Alveolar RMS was the most common histopathological type. A total of 16 patients were treated due to disease recurrence or a previous non‑radical surgical procedure, while 19 cases had inductive chemotherapy and/or radiotherapy preceding surgical treatment due to locally advanced disease. In 1 case, only diagnostic biopsy was performed. It is recommended that the management of H&N RMS is interdisciplinary from the beginning. Extensive surgical dissection in the H&N region for RMS may result in severe cosmetic defects and functional impairment; thus, these risks should be considered during treatment planning, and the surgical approach should be based on the individual characteristics of each patient.

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