Resection of a Deep Pubic Alveolar Rhabdomyosarcoma With an Inferior Pubic Ramus Osteotomy Through a Perineal...

Area of Science:

• Oncology
• Surgical Oncology
• Pediatric Oncology

Background:

• Alveolar rhabdomyosarcoma is a rare and aggressive soft tissue sarcoma.
• Pelvic rhabdomyosarcomas, particularly those involving the obturator internus muscle, are exceptionally uncommon.
• Limited literature exists on surgical approaches for obturator internus masses.

Purpose of the Study:

• To describe a case of alveolar rhabdomyosarcoma involving the pelvic structures.
• To present a successful surgical resection technique for a rare obturator internus muscle tumor.
• To highlight the preservation of neurovascular and urogenital function post-resection.

Main Methods:

• A 17-year-old male patient with pelvic alveolar rhabdomyosarcoma underwent neoadjuvant chemotherapy.
• A residual mass in the obturator internus muscle was surgically excised.
• The resection was performed via a perineal approach combined with an inferior pubic ramus osteotomy.

Main Results:

• The surgical approach facilitated complete tumor resection from the obturator internus muscle.
• Postoperative recovery was achieved with preservation of neurovascular and urogenital functions.
• No tumor recurrence was observed at the 24-month follow-up evaluation.

Conclusions:

• The perineal approach with inferior pubic ramus osteotomy is a viable and effective surgical strategy for resecting rare obturator internus muscle tumors.
• This technique allows for successful tumor removal while maintaining critical functional outcomes.
• This case adds to the limited literature, offering valuable insights into managing uncommon pelvic masses.