Silent Killer in the Nose: Two Cases of Nasal Alveolar Rhabdomyosarcoma in Adults
We report two cases of nasal alveolar rhabdomyosarcoma (ARMS) in adult patients from our center who presented with local mass effect and systemic involvement. Our first patient had spontaneous unilateral epistaxis. Her blood investigation showed severe thrombocytopenia, and the bone marrow biopsy re...
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| Published in: | Curēus (Palo Alto, CA) Vol. 15; no. 12; p. e50430 |
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Cureus Inc
13-12-2023
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| Abstract | We report two cases of nasal alveolar rhabdomyosarcoma (ARMS) in adult patients from our center who presented with local mass effect and systemic involvement. Our first patient had spontaneous unilateral epistaxis. Her blood investigation showed severe thrombocytopenia, and the bone marrow biopsy result showed bone marrow infiltration by non-hematopoietic malignant cells. Nasal endoscopy showed a mass arising medial to the left middle turbinate. Our second patient presented with right eye proptosis, associated with blurring of vision. Nasal endoscopy showed a right whitish nasal mass arising lateral to the middle turbinate. Both patients were diagnosed by immunohistochemical analysis showing ARMS, a soft tissue malignancy uncommon in adults. RMS in adults has a worse prognosis. Hence, the management is challenging. Early diagnostic workup is essential for the commencement of early treatment for better oncological outcomes. |
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| AbstractList | We report two cases of nasal alveolar rhabdomyosarcoma (ARMS) in adult patients from our center who presented with local mass effect and systemic involvement. Our first patient had spontaneous unilateral epistaxis. Her blood investigation showed severe thrombocytopenia, and the bone marrow biopsy result showed bone marrow infiltration by non-hematopoietic malignant cells. Nasal endoscopy showed a mass arising medial to the left middle turbinate. Our second patient presented with right eye proptosis, associated with blurring of vision. Nasal endoscopy showed a right whitish nasal mass arising lateral to the middle turbinate. Both patients were diagnosed by immunohistochemical analysis showing ARMS, a soft tissue malignancy uncommon in adults. RMS in adults has a worse prognosis. Hence, the management is challenging. Early diagnostic workup is essential for the commencement of early treatment for better oncological outcomes. We report two cases of nasal alveolar rhabdomyosarcoma (ARMS) in adult patients from our center who presented with local mass effect and systemic involvement. Our first patient had spontaneous unilateral epistaxis. Her blood investigation showed severe thrombocytopenia, and the bone marrow biopsy result showed bone marrow infiltration by non-hematopoietic malignant cells. Nasal endoscopy showed a mass arising medial to the left middle turbinate. Our second patient presented with right eye proptosis, associated with blurring of vision. Nasal endoscopy showed a right whitish nasal mass arising lateral to the middle turbinate. Both patients were diagnosed by immunohistochemical analysis showing ARMS, a soft tissue malignancy uncommon in adults. RMS in adults has a worse prognosis. Hence, the management is challenging. Early diagnostic workup is essential for the commencement of early treatment for better oncological outcomes. |
| Author | Arasu, Kanivannen Mohan Singh, Avatar Singh Ahmad Fahmi, Ahmad Kamil Kamel, Syafiqah Mianxin, Chew |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38222161$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1634/theoncologist.4-1-34 10.1002/cncr.11550 10.1073/pnas.91.21.9871 10.1177/0194599814551539 10.1186/2044-5040-2-25 10.1038/s41572-018-0051-2 |
| ContentType | Journal Article |
| Copyright | Copyright © 2023, Ahmad Fahmi et al. Copyright © 2023, Ahmad Fahmi et al. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| DOI | 10.7759/cureus.50430 |
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| Keywords | malignant soft tissue tumor nasal mass parameningeal tumor small round blue cell alveolar rhabdomyosarcoma |
| Language | English |
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| References | Dagher R (ref3) 1999; 4 Ferrari A (ref4) 2003; 98 Skapek SX (ref5) 2019; 5 Mao L (ref7) 1994; 91 Marshall AD (ref2) 2012; 2 Tsokos M (ref6) 1992; 116 Chang AE (ref1) 2014; 151 |
| References_xml | – volume: 116 year: 1992 ident: ref6 article-title: Rhabdomyosarcoma. A new classification scheme related to prognosis publication-title: Arch Pathol Lab Med contributor: fullname: Tsokos M – volume: 4 year: 1999 ident: ref3 article-title: Rhabdomyosarcoma: an overview publication-title: Oncologist doi: 10.1634/theoncologist.4-1-34 contributor: fullname: Dagher R – volume: 98 year: 2003 ident: ref4 article-title: Rhabdomyosarcoma in adults. A retrospective analysis of 171 patients treated at a single institution publication-title: Cancer doi: 10.1002/cncr.11550 contributor: fullname: Ferrari A – volume: 91 year: 1994 ident: ref7 article-title: Microsatellite alterations as clonal markers for the detection of human cancer publication-title: Proc Natl Acad Sci U S A doi: 10.1073/pnas.91.21.9871 contributor: fullname: Mao L – volume: 151 year: 2014 ident: ref1 article-title: Analysis of clinical prognostic factors for adult patients with head and neck sarcomas publication-title: Otolaryngol Head Neck Surg doi: 10.1177/0194599814551539 contributor: fullname: Chang AE – volume: 2 year: 2012 ident: ref2 article-title: Alveolar rhabdomyosarcoma - the molecular drivers of PAX3/7-FOXO1-induced tumorigenesis publication-title: Skelet Muscle doi: 10.1186/2044-5040-2-25 contributor: fullname: Marshall AD – volume: 5 year: 2019 ident: ref5 article-title: Rhabdomyosarcoma publication-title: Nat Rev Dis Primers doi: 10.1038/s41572-018-0051-2 contributor: fullname: Skapek SX |
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| SubjectTerms | Adults Biopsy Bone marrow Chemotherapy Comorbidity Endoscopy Epistaxis Medical prognosis Metastasis Otolaryngology Patients Radiation therapy Rhabdomyosarcoma Sarcoma Tumors |
| Title | Silent Killer in the Nose: Two Cases of Nasal Alveolar Rhabdomyosarcoma in Adults |
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