Rhabdomyosarcoma in the Nasal Cavity; A Case Report

A rare case of adult rhabdomyosarcoma originating from the left nasal cavity is reported. A 57year-old woman was referred to the Department of Otolaryngology, Kanazawa University, for investigation and treatment of a tumor in her left nasal cavity. Roentgenographic examination revealed a large left nasal mass without destruction of the surrounding bony tissue. Biopsy specimen from the tumor was pathologically suspected to be rhabdomyosarcoma.She was initially treated by radical resection via an extranasal approach. Pathological diagnosis of the resected specimen was alveolar rhabdomyosarcoma based on PAS staining and immunohistochemical staining. Systemic chemotherapy consisting of high-dose Vincristin and Actinomycin D was administered following radical resection, but was stopped due to severe muscular pain and intestinal paralysis. Following chemotherapy, irradiation was given and during the fourteen months following surgery, the patient has remained free from local or systemic recurrence.Rhabdomyosarcoma carries a worse prognosis than other sarcomas and chemotherapy is not as effective for adults as it is for children. Although curative surgery is important for alveolar rhabdomyosarcoma in adults, invasion to the central nervous system and distant metastasis to the lung are not rare. Therefore combined chemotherapy and irradiation are recommended.