Diagnosis and Multimodal Treatment of Metastatic Maxillofacial Juvenile Embryonal Rhabdomyosarcoma in a Young Golden...

A 2 yr old male castrated golden retriever was evaluated for a rapidly progressing maxillofacial spindle cell tumor. On examination, an ill-defined left maxillary mass, a 2 cm swelling under the left eye, and an enlarged left mandibular lymph node were noted. The dog was bright and alert but appeared painful upon jaw extension. Cytology from the lymph node revealed metastatic disease. Thoracic radiographs and computed tomography scan revealed pulmonary nodules. Computed tomography of the head and neck revealed a 6.7 × 4.1 × 6.5 cm mass at the rostral aspect of the left zygomatic arch invading the orbit. A second opinion of the biopsy specimen in conjunction with positive immunohistochemical staining for desmin led to a revised diagnosis of rhabdomyosarcoma. Treatment consisted of three doses of palliative radiation therapy, in 8 Gy fractions, and chemotherapy with vincristine, cyclophosphamide, and doxorubicin. A rapid clinical response was noted shortly after treatment initiation; however, the response was temporary, and the dog was euthanized due to widespread metastatic disease and associated clinical signs 74 days after initial therapy. This is one of the first reports describing positive results from multimodal treatment with chemotherapy and radiation therapy of a maxillofacial juvenile rhabdomyosarcoma in the veterinary literature.