Case Report: Pediatric Hepatic Rhabdomyosarcoma With Maximum Lifetime

Area of Science:

• Pediatric Oncology
• Surgical Pathology
• Medical Imaging

Background:

• Primary intrahepatic rhabdomyosarcoma is an exceptionally rare liver malignancy.
• Embryonal rhabdomyosarcoma typically affects younger populations, but intrahepatic presentation is exceedingly uncommon.

Observation:

• A 7-year-old boy presented asymptomatically with abnormal liver function and tumor markers.
• Imaging identified a large left lobe liver mass; initial biopsy misdiagnosed it as clear cell sarcoma.
• Postoperative histopathology and immunohistochemistry (desmin, myogenin positive) confirmed hepatic embryonal rhabdomyosarcoma.

Findings:

• The patient underwent neoadjuvant chemotherapy, radiotherapy, and adjuvant chemotherapy.
• Histopathology and immunohistochemistry confirmed the diagnosis of hepatic embryonal rhabdomyosarcoma.
• The patient showed no recurrence or metastasis on imaging for 13 months and survived over 38 months post-diagnosis.

Implications:

• This case highlights the importance of comprehensive diagnostic workup for rare liver tumors.
• Successful application of neoadjuvant chemotherapy followed by multimodal treatment offers a promising therapeutic strategy.
• This represents the first reported case of hepatic rhabdomyosarcoma achieving a favorable outcome with neoadjuvant chemotherapy.