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Bone tumors in children: Round cell sarcoma of the thigh: A case report
Bugashane Bwa Mihigo Elie1, Chasinga Baharanyi Tshass2, Balagizi Ganywamulume3
1Surgery Department, Faculty of medicine and public health, Evangelical University in Africa, Bukavu, South Kivu, Congo; Surgery Department, Panzi General Referral Hospital, Bukavu, South Kivu, Congo.
Insights
This case study highlights a rare round cell sarcoma in an 18-month-old infant's femur. Early diagnosis and multidisciplinary management are crucial for improving outcomes in pediatric bone tumors.
Area of Science:
- Pediatric Oncology
- Skeletal Malignancies
- Rare Pediatric Cancers
Background:
- Bone tumors constitute approximately 5% of all pediatric cancers, predominantly affecting the limbs.
- Round cell sarcomas are a significant subtype, posing diagnostic and therapeutic challenges in young children.
Observation:
- An 18-month-old female infant presented with a month-long history of a painful, progressively enlarging right thigh mass and ipsilateral inguinal adenopathy.
- Initial investigations revealed a round cell sarcoma of the femur; immunohistochemistry was unavailable.
Findings:
- The case underscores the rarity of early-onset bone tumors and the diagnostic complexities in infants.
- Delayed presentation with complications like infection or distant signs is common, complicating management.
Implications:
- Optimal management involves a multidisciplinary approach, including chemotherapy and conservative surgical resection to avoid limb amputation.
- Psychological support for families and healthcare teams is vital due to the challenges and poor prognosis associated with infant sarcomas.
Introduction And Importance:
Bone tumor in children is a very large pathology and represents about 5% of pediatric cancers located mainly in the limbs. This is a case of a rare form of bone tumor of the round cell sarcoma type of the right femur in an 18-month-old female infant whose diagnosis and therapeutic decision are specific.
Case Presentation:
We present an 18-month-old girl, admitted to the panzi general reference hospital and presenting a painful swelling of the right thigh evolving for more than a month and which gradually increased in size in a febrile context with ipso-lateral inguinal adenopathy; Bone biopsy revealed round cell sarcoma and immunohistochemistry was not available. While waiting for chemotherapy, the proposed surgery was a hip disarticulation in an 18-month-old girl.
Clinical Discussion:
Early discovery of the tumor at infant age is rare, it can occur in any part of the limb. The lower end of the femur and the upper end of the tibia or fibula account for 60% of cases. Its diagnosis is not easy, the management and improvement of the prognosis are linked to the use of chemotherapy and local treatment and conservative surgical resection, avoiding amputation or disarticulation. It is not easy to accept, neither for the child's parents nor for the healthcare team.
Conclusion:
Thigh sarcoma in an infant is rare and atypically discovered when faced with complications, infection or remote signs with difficulty in diagnosis and management; multidisciplinarity is very necessary, also involving psychologists despite the poor prognosis.
