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Persistent mass after treatment for orbital rhabdomyosarcoma
Jonathan C Siktberg1, Alexandra E Kovach2, Scott C Borinstein3
1Vanderbilt University School of Medicine, 1161 21st Ave S # D3300, Nashville, TN, USA, 37232.
American Journal of Ophthalmology Case Reports
|February 2, 2022
Summary
Orbital rhabdomyosarcoma treatment can leave a residual mass, posing a diagnostic challenge. This case shows a residual mass after treatment was completely treated tumor, not active disease.
Area of Science:
- Pediatric Oncology
- Ophthalmology
- Radiation Oncology
Background:
- Orbital rhabdomyosarcoma presents unique challenges in pediatric oncology.
- Advances in chemotherapy and radiation have improved outcomes, shifting treatment from surgery to medical management.
Observation:
- A case of Stage 1, Group III embryonal rhabdomyosarcoma in an 11-year-old boy's orbit is presented.
- Following 24 weeks of chemotherapy and radiation, a persistent mass with medial wall erosion was noted.
- The erosion raised uncertainty between radiation osteonecrosis and tumor progression, creating a treatment dilemma.
Findings:
- A planned biopsy revealed the residual mass was completely treated tumor, not active rhabdomyosarcoma.
- Complete excision of the mass was performed due to ease of removal during the biopsy procedure.
- Four-year MRI surveillance confirmed the patient remains tumor-free.
Implications:
- Residual masses after orbital rhabdomyosarcoma treatment can represent completely treated tumor.
- This highlights the importance of careful evaluation and potential for conservative management in such cases.
- Improved diagnostic and therapeutic strategies are crucial for managing residual disease in pediatric orbital tumors.
