Pleomorphic Rhabdomyosarcoma on the Lumbal in Adult Patient: A Case Report

Abstract

BACKGROUND: The incidence of Rhabdomyosarcoma in children found at the top of age 5-15 years, with median age about 10 years. In adult, the tumor occurs about 10 % of all cases. PRMS is a very rare subtype of RMS and almost exclusively in male patient older than 45 years. Approximately 40% of RMS occurs in the head and neck region, RMS in the trunk is rare. RMS arising from the paraspinal area only comprises 3.3% of all cases.   CASE REPORTS: This case report described a 38 years-old male with lump on his back, since 1 year ago and enlarge slowly until bigger than a tennis ball, with no neurological deficit. Based on MRI with contrast there’s a solid mass on the subcutis on the level L4-5 with size 7,5 x 3 x 7,2 cm. Patient was underwent wide excision and the histopathology examination was referred to Pleomorphic Rhabdomyosarcoma. Patient underwent radiotherapy procedure for 1 month in outpatient clinic, with maximum dose radiotherapy 60 Gy, and patient underwent 30 times session of radiotherapy with dose 2 Gy for each session. After 1,5 years of control there’s no sign of recurrences.                                                                                                                              RESULTS: Based on clinical, radiologic, and histological examination, the diagnosis of pleomorphic rhabdomyosarcoma confirmed by an expert pathology consultant. Immunohistochemical examination was performed, and patient underwent wide excision and definitive radiotherapy.   DISCUSSION: Pleomorphic Rhabdomyosarcoma on the back is extremely rare and difficult to distinguish histologically. This is a very valuable case, which highlights the need for orthopedic surgeons to re-evaluate clinical and histologic finding carefully when diagnosing patients with soft tissue tumor on the lumbal region.