Pediatric Prostatic Alveolar Rhabdomyosarcoma Presenting with Metastatic Spinal Cord Compression in the Thoracic Spine: A Case Report and Review of the Literature

TL;DR

A child with a rare type of rhabdomyosarcoma in the prostate developed spinal cord compression and metastases, highlighting treatment challenges for advanced cases.

Contribution

First reported case of prostatic rhabdomyosarcoma in a child presenting with thoracic spinal cord compression.

Findings

The patient received multimodal treatment but experienced disease progression after six months.

This case emphasizes the difficulty in managing metastatic rhabdomyosarcoma in pediatric patients.

Spinal cord compression as a metastatic site is a rare and challenging clinical presentation.

Abstract

Rhabdomyosarcoma (RMS) is a pediatric malignancy with a variable prognosis depending on tumor stage and genotype. There has been a significant improvement in survival rates over the past decades. However, aggressive variants can metastasize to locations that are difficult to treat. We report a case of prostatic alveolar rhabdomyosarcoma with metastases to the bone marrow and thoracic spine in a child. The patient was treated with a multimodal approach that included surgical resection of the epidural mass; the administration of vincristine, dactinomycin, and cyclophosphamide; and radiotherapy. Unfortunately, after six months, the patient showed disease progression and was started on secondary-line treatment. This case illustrates the difficulties in managing end-stage metastatic rhabdomyosarcoma and is the first report of prostatic rhabdomyosarcoma presenting with spinal cord compression in a child.

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