Successful management strategy for giant primary hepatic rhabdomyosarcoma in 15-year-old male: a case report

Muhamad Zakaria Brimo Alsaman; Roaa Ghanem; Mohamad Ali Nahas; Eyad M Chatty; Hasan A Hasan; Zeinab Nabil Othman; Rafat Horoub

doi:10.1093/jscr/rjad707

Successful management strategy for giant primary hepatic rhabdomyosarcoma in 15-year-old male: a case report

J Surg Case Rep. 2024 Jan 18;2024(1):rjad707. doi: 10.1093/jscr/rjad707. eCollection 2024 Jan.

Authors

Muhamad Zakaria Brimo Alsaman^{1

2}, Roaa Ghanem^{2

3}, Mohamad Ali Nahas^{4

5}, Eyad M Chatty^{5

6}, Hasan A Hasan^{5

7}, Zeinab Nabil Othman^{5

7

8}, Rafat Horoub^{5

9}

Affiliations

¹ Vascular Surgery Department, Al-Razi Hospital, Aleppo 963, Syria.
² Faculty of Medicine, Aleppo University, Aleppo 963, Syria.
³ Public Health Department, Centre of Strategic Studies and Health Training, Damascus 963, Syria.
⁴ Vascular and Endovascular Surgery Department, Al-Assad University Hospital, Damascus 963, Syria.
⁵ Faculty of Medicine, Damascus University, Damascus 963, Syria.
⁶ Pathology Department, Al-Assad University Hospital, Damascus 963, Syria.
⁷ Oncology Department, Al-Amal Center, Damascus 963, Syria.
⁸ Oncology Department, Al-Bairuni University Hospital, Damascus 963, Syria.
⁹ General Surgery Department, Al-Assad University Hospital, Damascus 963, Syria.

Abstract

Primary hepatic rhabdomyosarcoma is an exceedingly rare type of sarcomas. A 15-year-old boy was admitted to the hospital with abdominal pain. Serial investigation showed a giant heterogeneous mass, with a diameter of 15 cm, located in the right lobe of the liver (segment 4a, 4b, 5, 6, 7, 8), with clear margins, non-homogeneous density in computerized tomography and the Positron Emission Tomography Scan Multi Slice revealed a peripherally slightly metabolically active hepatic mass (205 × 134 × 208 mm). Histopathological examination and the Immunohistochemical showed embryonal rhabdomyosarcoma. The management strategy involved multiple cycles of ifosfamide and doxorubicin and monitoring the tumor size, until the tumor size was suitable for the surgery. The management of hepatic rhabdomyosarcoma is a surgical challenge due to the late onset of symptoms, a limited number of reported cases, and poor prognosis. Surgical excision is the treatment of choice for primary hepatic rhabdomyosarcoma and combination between chemotherapy, surgery showed good results.

Keywords: case report; liver; rhabdomyosarcoma.

Publication types

Case Reports