Orbital rhabdomyosarcoma with skin metastasis: a case report

Rhabdomyosarcoma is a soft tissue neoplasm that usually arises in the head and neck region and genitourinary tract. Skin metastasis of rhabdomyosarcoma is extremely rare; of thirteen cases reported in the literature, most were children younger than 10 years and only three cases have been reported in adults.

A 20-year-old Moroccan man was admitted with a right orbital tumor. The tumor was excised and histopathology examination confirmed a diagnosis of rhabdomyosarcoma. The patient was treated with chemotherapy, but local recurrence occurred one year later. The patient underwent right orbital exenteration followed by chemotherapy and radiotherapy. After 6 months, the patient developed a cutaneous mass in the right lumbar region, which was resected. Immunohistochemical examination of the tumor showed this to be a cutaneous metastasis of rhabdomyosarcoma. The patient was treated by chemotherapy and there appeared to be no recurrence after 9 months of follow up.

Skin metastasis from rhabdomyosarcoma is extremely rare, particularly in adults. The purpose of presenting this case report is to raise awareness among clinicians--skin biopsy and immunohistochemistry are needed to distinguish this neoplasm from other cutaneous tumors so that appropriate treatment can be initiated.