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Amougou B, Eyongeta D, Engbang JP, Beyeme TS, Cisse D, Ngandeu MJ, Sow Y, Diallo AB. [Paratesticular rhabdomyosarcoma: about a case and literature review]. Pan Afr Med J 2021; 39:71. [PMID: 34422194 PMCID: PMC8363974 DOI: 10.11604/pamj.2021.39.71.29224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/10/2021] [Indexed: 11/21/2022] Open
Abstract
Nous rapportons une observation d´un rhabdomyosarcome embryonnaire paratesticulaire chez un adulte jeune et soulignons le caractère inhabituel de cette forme histologique dans cette tranche d´âge, l´évolution rapide de la lésion ainsi que les difficultés de prise en charge de ce type de tumeurs dans notre contexte.
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Affiliation(s)
- Boris Amougou
- Département de Chirurgie et Spécialités Chirurgicales, Faculté de Médecine et des Sciences Pharmaceutiques, Université de Dschang, Dschang, Cameroun
| | - Divine Eyongeta
- Départements d´Anatomie et de Chirurgie, Faculté de Médecine, Université de Buea, Département d'Urologie, Hôpital Régional de Limbé, Limbé, Cameroun
| | - Jean Paul Engbang
- Faculté de Médecine et des Sciences Pharmaceutiques de l´Université de Douala, Douala, Cameroun
| | | | - Demba Cisse
- Faculté de Médecine et de Pharmacie de l´Université Gamal Abdel Nasser de Conakry, Conakry, Guinée
| | | | - Yaya Sow
- Faculté de Médecine, Pharmacie et Odonto-Stomatologie, Université Cheikh Anta Diop, Service d´Urologie, Hôpital Aristide Le Dantec, Dakar, Sénégal
| | - Abdoulaye Bobo Diallo
- Département de Chirurgie et Spécialités Chirurgicales, Faculté de Médecine et de Pharmacie de l´Université Gamal Abdel Nasser de Conakry, Conakry, Guinée
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Graiouid EM, Chakir Y, Gallouo M, Dakir M, Debbagh A, Aboutaieb R. [Paratesticular rhabdomyosarcoma: a case report]. Pan Afr Med J 2019; 33:55. [PMID: 31448017 PMCID: PMC6690064 DOI: 10.11604/pamj.2019.33.55.17269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 04/02/2019] [Indexed: 11/21/2022] Open
Abstract
Le rhabdomyosarcome (RMS) para-testiculaire est une tumeur rare. Le traitement doit être multimodal et fait appel à la chirurgie, à la chimiothérapie et à la radiothérapie. À la lumière de cette observation et d'une revue de la littérature, les auteurs discuteront les modalités diagnostiques et thérapeutiques.
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Affiliation(s)
| | | | | | | | - Adil Debbagh
- Service d'Urologie, CHU Ibn Rochd, Casablanca, Maroc
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3
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Boudahna L, Benbrahim Z, Amaadour L, Mazouz A, Benhayoune K, Tahiri Y, Farih MH, Amarti A, Arifi S, Mellas N. Para testicular rhabdomyosarcoma in adults: three case reports and review of literature. Pan Afr Med J 2014; 19:279. [PMID: 25870734 PMCID: PMC4391901 DOI: 10.11604/pamj.2014.19.279.4784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 11/11/2014] [Indexed: 12/21/2022] Open
Abstract
Paratesticular embryonal rhabdomyosarcoma (RMS) is a rare tumor arising from the mesenchymal tissues of the spermatic cord, epididymis, testis and testicular tunics. We report three cases of adult paratesticular RMS, two embryonic and one pleomorphic rhabdomyosarcoma. All the patients underwent diagnostic orchidectomy. The work up investigations revealed lung metastases. Chemotherapy with Ifosfamide and Doxorubicin was used in two cases, whereas Vincristin- Actinomycin D and Cyclophosphamide was received in one case. An objective partial response was reported in 2 cases, with complete response in one case. Paratesticular RMS is a rare and aggressive tumor. Because of the absence of protocols designed specifically for adult patients, it is necessary to follow therapeutic guidelines in pediatric protocols.
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Affiliation(s)
- Lamiae Boudahna
- Medical Oncology Department, Hassan II University Hospital, Fez, Morocco
| | - Zineb Benbrahim
- Medical Oncology Department, Hassan II University Hospital, Fez, Morocco
| | - Lamiae Amaadour
- Medical Oncology Department, Hassan II University Hospital, Fez, Morocco
| | - Aicha Mazouz
- Medical Oncology Department, Hassan II University Hospital, Fez, Morocco
| | | | - Yassir Tahiri
- Urology department, Hassan II University Hospital, Fez, Morocco
| | | | - Afaf Amarti
- Laboratory of Pathology, Hassan II University Hospital, Fez, Morocco
| | - Samia Arifi
- Medical Oncology Department, Hassan II University Hospital, Fez, Morocco
| | - Nawfel Mellas
- Medical Oncology Department, Hassan II University Hospital, Fez, Morocco
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Kumar R, Kapoor R, Khosla D, Kumar N, Ghoshal S, Mandal AK, Radotra BD, Sharma SC. Paratesticular rhabdomyosarcoma in young adults: A tertiary care institute experience. Indian J Urol 2013; 29:110-3. [PMID: 23956511 PMCID: PMC3737665 DOI: 10.4103/0970-1591.114030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Introduction: Paratesticular rhabdomyosarcoma (RMS) is a rare tumor arising from the mesenchymal tissues of the spermatic cord, epididymis, testis and testicular tunics. It represents only 7% of all patients entered in the Intergroup Rhabdomyosarcoma Study (IRS) and 17% of all malignant intrascrotal tumors in children less than 15 years old. We present our experience in combined modality management of 10 successive patients of paratesticular RMS. Material and Methods: We retrospectively reviewed 10 patients of paratesticular RMS treated in our institute from July 2004 to December 2010. Clinical characteristics and treatment modality in form of surgery and chemotherapy (CCT) were noted. Statistical analysis was done with regards to progression-free survival (PFS) and overall survival (OS) using Kaplan-Meier survival analysis. Results: The median age of the patients was 16.5 years. The median duration of symptoms was 5 months. Five patients had retroperitoneal lymphadenopathy (RPLAP) while three had lung metastases and one had orbital metastases. All patients underwent high inguinal orchidectomy followed by systemic chemotherapy (CCT). Retroperitoneal node dissection was not a required staging procedure. Four patients had partial response to treatment while six had complete response. Mean duration of PFS was 48 months and mean OS was 56 months. Conclusions: Paratesticular RMS are rare neoplasms with aggressive growth patterns. Cure rates have dramatically improved and 60% of patients in our series had complete response. This success is due to development of multimodality and risk adapted treatment approaches.
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Affiliation(s)
- Ritesh Kumar
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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5
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Faure A, Diakité ML, Panait N, Chaumoître K, Rome A, Merrot T. [Paratesticular rhabdomyosarcoma in children: a scrotal emergency]. Arch Pediatr 2012; 19:1340-4. [PMID: 23122662 DOI: 10.1016/j.arcped.2012.09.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 07/31/2012] [Accepted: 09/27/2012] [Indexed: 11/18/2022]
Abstract
Paratesticular rhabdomyosarcoma is a rare and highly aggressive embryonal tumor in infancy and childhood. The tumor is intrascrotal, localized in the spermatic cord, the epididymis, or in the tunica vaginalis. Rhabdomyosarcoma represents 10% of testicular tumors of infancy. On physical examination, a painless scrotal tumefaction is observed. A surgical and pathological classification is used to group patients according to the extent of residual tumor after the initial surgical procedure: Intergroup Rhabdomyosarcoma Study classification (IRS). Multimodality therapy involving surgery, chemotherapy, and radiotherapy is necessary. Depending on the extent of disease and the staging group, the approach of treatment is different. The most important factors affecting treatment outcome are the stage, the pathological subtype of the tumor, and the age of the patient. Younger patients (<10 years) with a local tumor and with embryonal pathology have an excellent prognosis. We report the case of a 6-year-old boy admitted for a specialist consultation because of the recent appearance of a tumor in the right scrotum. On physical examination, a painless, solid, right scrotal mass was noted and the diagnosis of paratesticular rhabdomyosarcoma was made. This diagnosis can be suspected on physical and on ultrasound examinations, but only a pathological examination will confirm it. The authors discuss the therapeutic issues raised by this lesion and report one case of paratesticular rhabdomyosarcoma.
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Affiliation(s)
- A Faure
- Service de chirurgie pédiatrique, assistance publique, hôpital Nord Marseille, pavillon mère-enfant, Aix-Marseille université, chemin des Bourrelys, 13915 Marseille cedex 20, France.
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Ferrari A, Bisogno G, Casanova M, Meazza C, Piva L, Cecchetto G, Zanetti I, Pilz T, Mattke A, Treuner J, Carli M. Paratesticular rhabdomyosarcoma: report from the Italian and German Cooperative Group. J Clin Oncol 2002; 20:449-55. [PMID: 11786573 DOI: 10.1200/jco.2002.20.2.449] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE We report the experience of the German-Italian Cooperative Group with 216 pediatric patients with paratesticular rhabdomyosarcoma treated over 20 years. PATIENTS AND METHODS At diagnosis, 198 patients had localized disease and 18 had distant metastases. Among the nonmetastatic patients, complete tumor resection was performed in 83% of cases. Evaluation of the retroperitoneal lymph nodes changed over the years from routine surgical staging to radiologic assessment. All patients received chemotherapy, which was reduced in intensity and duration for patients with low-risk features in subsequent protocols. Radiotherapy was administered to 10% of patients. RESULTS Among 72 patients with a negative retroperitoneal computed tomography (CT) scan, surgical assessment detected nodal involvement in only one case. Among 23 patients with enlarged nodes on CT scans, surgery confirmed nodal spread in 65% of patients. No differences in the rate of nodal involvement were observed over the years. With a median follow-up of 110 months, 5-year survival was 85.5% for the series as a whole, 94.6% for patients with localized disease, and 22.2% for metastatic cases. Retroperitoneal nodal recurrence was the major cause of treatment failure. Univariate analysis revealed the prognostic value of tumor invasiveness, size, and resectability, as well as of nodal involvement and age, in patients with localized tumor. CONCLUSION The outcome for patients with localized paratesticular rhabdomyosarcoma is excellent, despite the reduction in chemotherapy over the years: an alkylating agent-free and anthracycline-free regimen is adequate treatment for low-risk patients. Surgical assessment of the retroperitoneum must be reserved for patients with enlarged nodes on CT scans. Children over 10 years old carry a higher risk of nodal involvement and relapse.
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Affiliation(s)
- A Ferrari
- Pediatric Oncology and Pediatric Surgery Units, Istituto Nazionale Tumori, Milan, Italy.
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Abstract
Dramatic improvements have occurred in the treatment and prognosis of the child with rhabdomyosarcoma over the past 2 decades. Increased understanding of tumor behavior has improved survival and focused attention on important quality of life issues. Future therapeutic advances will depend largely on an improved molecular understanding of altered cell behavior and the continued efforts of multi-institutional studies.
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Affiliation(s)
- M Kaefer
- Department of Pediatric Urology, James Whitcomb Riley Hospital for Children, Indiana University Medical Center, Indianapolis, USA
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de Camargo B, Salateo R, Gutierrez y Lamelas R, Cardoso H, Hayashi M, Arias V. Unusual clinical evolution of a paratesticular alveolar rhabdomyosarcoma in a child. MEDICAL AND PEDIATRIC ONCOLOGY 1999; 33:422-4. [PMID: 10491559 DOI: 10.1002/(sici)1096-911x(199910)33:4<422::aid-mpo20>3.0.co;2-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- B de Camargo
- Pediatric Department, Hospital do Cancer, São Paulo, Brazil.
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Hermans BP, Foster RS, Bihrle R, Little S, Sandler A, Einhorn LH, Donohue JP. Is retroperitoneal lymph node dissection necessary for adult paratesticular rhabdomyosarcoma? J Urol 1998. [PMID: 9817327 DOI: 10.1016/s0022-5347(01)62246-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE We assess the benefit of retroperitoneal lymph node dissection for adult paratesticular rhabdomyosarcoma. MATERIALS AND METHODS A total of 19 adults with paratesticular rhabdomyosarcoma who underwent retroperitoneal lymph node dissection between 1980 and 1997 comprise our study population. Postoperative chemotherapy was administered in all patients, including cyclophosphamide, doxorubicin and vincristine with or without consolidation with ifosfamide and etoposide in 17, and vincristine, actinomycin D and cyclophosphamide in 2. Radiation therapy also was administered in 2 patients. Patients were classified into pathological and clinical groups according to the Intergroup Rhabdomyosarcoma Studies. Mean followup was 6.4 years (range 0.5 to 17.6). RESULTS A total of 17 patients (89%) were disease-free and 2 (1 in pathological group I and 1 in pathological group II) died of disease that recurred outside of the retroperitoneum. Of 16 clinical group I patients 9 were in pathological group II. There were negative nodes in 2 of 3 clinical group II patients. Thus, abdominal computerized tomography correctly staged only 8 of 19 patients (42%). CONCLUSIONS Retroperitoneal lymph node dissection accurately stages paratesticular rhabdomyosarcoma and eliminates the need for abdominal radiotherapy in patients in pathological group II. Combined modality therapy with retroperitoneal lymph node dissection and postoperative chemotherapy achieves a high cure rate.
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Affiliation(s)
- B P Hermans
- Department of Urology, Indiana University Medical Center, Indianapolis, USA
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Hermans BP, Foster RS, Bihrle R, Little S, Sandler A, Einhorn LH, Donohue JP. Is retroperitoneal lymph node dissection necessary for adult paratesticular rhabdomyosarcoma? J Urol 1998; 160:2074-7. [PMID: 9817327 DOI: 10.1097/00005392-199812010-00036] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE We assess the benefit of retroperitoneal lymph node dissection for adult paratesticular rhabdomyosarcoma. MATERIALS AND METHODS A total of 19 adults with paratesticular rhabdomyosarcoma who underwent retroperitoneal lymph node dissection between 1980 and 1997 comprise our study population. Postoperative chemotherapy was administered in all patients, including cyclophosphamide, doxorubicin and vincristine with or without consolidation with ifosfamide and etoposide in 17, and vincristine, actinomycin D and cyclophosphamide in 2. Radiation therapy also was administered in 2 patients. Patients were classified into pathological and clinical groups according to the Intergroup Rhabdomyosarcoma Studies. Mean followup was 6.4 years (range 0.5 to 17.6). RESULTS A total of 17 patients (89%) were disease-free and 2 (1 in pathological group I and 1 in pathological group II) died of disease that recurred outside of the retroperitoneum. Of 16 clinical group I patients 9 were in pathological group II. There were negative nodes in 2 of 3 clinical group II patients. Thus, abdominal computerized tomography correctly staged only 8 of 19 patients (42%). CONCLUSIONS Retroperitoneal lymph node dissection accurately stages paratesticular rhabdomyosarcoma and eliminates the need for abdominal radiotherapy in patients in pathological group II. Combined modality therapy with retroperitoneal lymph node dissection and postoperative chemotherapy achieves a high cure rate.
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Affiliation(s)
- B P Hermans
- Department of Urology, Indiana University Medical Center, Indianapolis, USA
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Affiliation(s)
- B Bhushan
- Department of Radiology, Armed Forces Hospital, Muscat, Sultante of Oman
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12
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Rogers DA, Rao BN, Meyer WH, Pappo A, Lobe TE, Fleming ID, Kauffman WM. Indications for hemiscrotectomy in the management of genitourinary tumors in children. J Pediatr Surg 1995; 30:1437-9. [PMID: 8786482 DOI: 10.1016/0022-3468(95)90400-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In the last 30 years at St Jude Children's Research Hospital, 10 boys have undergone hemiscrotectomy for primary testicular tumors or paratesticular rhabdomyosarcoma. Indications for this procedure were scrotal contamination and positive or uncertain surgical margins. Residual tumor was found in only one specimen. There were four complications in the study group. Two patients had complications directly attributable to the hemiscrotectomy, and in one patient this caused a delay in treatment. Preoperative imaging was performed in three patients. This has not been helpful in evaluating residual masses and is not indicated. Based on the authors' experience and a review of the literature, there are a number of indications for hemiscrotectomy in the management of genitourinary tumors in children. Controversies regarding some of these indications should be discussed with the families of these patients during preoperative counseling.
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Affiliation(s)
- D A Rogers
- Department of Surgery, St Judge Children's Research Hospital, Memphis TN 38105, USA
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Goldfarb B, Khoury AE, Greenberg ML, Churchill BM, Smith CR, McLorie GA. The role of retroperitoneal lymphadenectomy in localized paratesticular rhabdomyosarcoma. J Urol 1994; 152:785-7. [PMID: 8022014 DOI: 10.1016/s0022-5347(17)32709-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Between 1985 and 1990, 10 cases of embryonal paratesticular rhabdomyosarcoma were treated at our institution. Patient age ranged from 5 months to 16 years at presentation (mean 8.7 years). Chest and abdominal computerized tomography (CT) was performed on all patients. Lymphangiography was performed on 2 patients, and 6 underwent retroperitoneal lymphadenectomy, due to suspicious CT (2) and a positive lymphangiogram (1). All 6 patients had pathologically negative nodes, and they received vincristine, actinomycin D and cyclophosphamide for 8 to 13 months (mean 10.6 months). Four patients also received doxorubicin. The 10 patients are alive and the disease is in complete remission for a mean 6.02-year disease-free survival. These data support the hypothesis that retroperitoneal lymphadenectomy can be avoided for paratesticular rhabdomyosarcoma after radical inguinal orchiectomy when CT is negative for nodal involvement.
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Affiliation(s)
- B Goldfarb
- Division of Urology, Hospital for Sick Children, Toronto, Ontario, Canada
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Hughes LL, Baruzzi MJ, Ribeiro RC, Ayers GD, Rao B, Parham DM, Pratt CB, Kun LE. Paratesticular rhabdomyosarcoma: delayed effects of multimodality therapy and implications for current management. Cancer 1994; 73:476-82. [PMID: 8293416 DOI: 10.1002/1097-0142(19940115)73:2<476::aid-cncr2820730237>3.0.co;2-n] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND The combined modalities of surgery, chemotherapy, and radiation therapy have greatly improved the survival rate in childhood paratesticular rhabdomyosarcoma, but the incidence of complications and late side effects is a cause for concern. METHODS We reviewed the records of 18 patients treated for paratesticular rhabdomyosarcoma at St. Jude Children's Research Hospital between 1962 and 1989. Patients with Group I disease were treated with orchiectomy, retroperitoneal lymph node dissection, and multi-agent chemotherapy; more advanced cases also received radiation therapy with concurrent chemotherapy. RESULTS Sequelae included esophageal and common bile duct stricture, inguinal nerve entrapment syndrome, and small bowel obstruction. Short stature was found in all children whose spines were irradiated via para-aortic fields (34-37 Gy) prior to puberty. Two of 18 patients died from treatment complications and one from progressive disease. CONCLUSIONS Multimodality treatment offers an excellent prognosis in paratesticular rhabdomyosarcoma, but is associated with significant morbidity and mortality rates. A discussion of therapy components and their application to disease stages suggests possible approaches to optimizing treatment for this therapy-sensitive malignancy.
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Affiliation(s)
- L L Hughes
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38101
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Affiliation(s)
- C B Pratt
- Department of Hematology/Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38101
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