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Cavalcante IL, Cunha JLS, da Silva CCB, Nonaka CFW, Cavalcante ER, de Almeida OP, Ribeiro NRB, Turatti E, Cavalcante RB, de Andrade BAB. Gingival rhabdomyosarcoma mimicking a non-neoplastic proliferative lesion: A diagnostic challenge. Oral Oncol 2023; 137:106281. [PMID: 36549241 DOI: 10.1016/j.oraloncology.2022.106281] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
Rhabdomyosarcoma (RMS) is a soft tissue sarcoma that develops from skeletal striated muscle cells. RMSs are exceedingly rare in the oral cavity, particularly in the gingiva. Herein, we reported the clinicopathological and immunohistochemical features of a rare case of RMS in a 30-year-old female presenting clinically as a painful polypoid nodule on the mandibular gingiva. Microscopically, the tumor showed atypical spindle cells with elongated nuclei and eosinophilic cytoplasm arranged in a fascicular pattern. In focal areas, the tumor cells exhibited rhabdomyoblastic differentiation. Immunohistochemistry showed strong positivity for desmin, myogenin (scattered cells), and MyoD1. The patient underwent surgical resection followed by postoperative complementary radio- and chemotherapy. However, the patient had a local recurrence seven months after the initial treatment. She was submitted to a total mandibulectomy associated with adjuvant radiotherapy. However, she died two months after reoperation due to complications secondary to radiation therapy. Because of the rarity in the oral cavity and non-specific signs and symptoms, the clinical diagnosis of RMS is difficult and often overlooked. Therefore, careful histopathological and immunohistochemistry analysis of these tumors is essential to correct diagnosis. Early surgical excision with tumor-free margins and prolonged follow-up are strongly recommended.
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Affiliation(s)
- Israel Leal Cavalcante
- Department of Dentistry, University of Fortaleza (UNIFOR), Fortaleza, Brazil; Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
| | - John Lennon Silva Cunha
- Department of Dentristy, State University of Paraíba (UEPB), Campina Grande, Brazil; Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil.
| | - Caio Cesar Barros da Silva
- Department of Dentistry, Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | | | | | - Oslei Paes de Almeida
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | | | - Eveline Turatti
- Department of Dentistry, University of Fortaleza (UNIFOR), Fortaleza, Brazil.
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Li Q, Zhang L, Jiang J, Zhang Y, Wang X, Zhang Q, Wang Y, Liu C, Li F. CDK1 and CCNB1 as potential diagnostic markers of rhabdomyosarcoma: validation following bioinformatics analysis. BMC Med Genomics 2019; 12:198. [PMID: 31870357 PMCID: PMC6929508 DOI: 10.1186/s12920-019-0645-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 12/12/2019] [Indexed: 12/27/2022] Open
Abstract
Background Rhabdomyosarcoma (RMS), a common soft-tissue malignancy in pediatrics, presents high invasiveness and mortality. However, besides known changes in the PAX3/7-FOXO1 fusion gene in alveolar RMS, the molecular mechanisms of the disease remain incompletely understood. The purpose of the study is to recognize potential biomarkers related with RMS and analyse their molecular mechanism, diagnosis and prognostic significance. Methods The Gene Expression Omnibus was used to search the RMS and normal striated muscle data sets. Differentially expressed genes (DEGs) were filtered using R software. The DAVID has become accustomed to performing functional annotations and pathway analysis on DEGs. The protein interaction was constructed and further processed by the STRING tool and Cytoscape software. Kaplan–Meier was used to estimate the effect of hub genes on the ending of sarcoma sufferers, and the expression of these genes in RMS was proved by real-time polymerase chain reaction (RT-PCR). Finally, the expression of CDK1 and CCNB1 in RMS was validated by immunohistochemistry (IHC). Results A total of 1932 DEGs were obtained, amongst which 1505 were up-regulated and 427were down-regulated. Up-regulated genes were largely enriched in the cell cycle, ECM-receptor interaction, PI3K/Akt and p53 pathways, whilst down-regulated genes were primarily enriched in the muscle contraction process. CDK1, CCNB1, CDC20, CCNB2, AURKB, MAD2L1, HIST2H2BE, CENPE, KIF2C and PCNA were identified as hub genes by Cytoscape analyses. Survival analysis showed that, except for HIST2H2BE, the other hub genes were highly expressed and related to poor prognosis in sarcoma. RT-PCR validation showed that CDK1, CCNB1, CDC20, CENPE and HIST2H2BE were significantly differential expression in RMS compared to the normal control. IHC revealed that the expression of CDK1 (28/32, 87.5%) and CCNB1 (26/32, 81.25%) were notably higher in RMS than normal controls (1/9, 11.1%; 0/9, 0%). Moreover, the CCNB1 was associated with the age and location of the patient’s onset. Conclusions These results show that these hub genes, especially CDK1 and CCNB1, may be potential diagnostic biomarkers for RMS and provide a new perspective for the pathogenesis of RMS.
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Affiliation(s)
- Qianru Li
- Department of Pathology, Shihezi University School of Medicine and The Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Chinese Ministry of Education, Shihezi, Xinjiang, 832002, China
| | - Liang Zhang
- Department of Pathology, Shihezi University School of Medicine and The Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Chinese Ministry of Education, Shihezi, Xinjiang, 832002, China.,Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People's Republic of China
| | - Jinfang Jiang
- Department of Pathology, Shihezi University School of Medicine and The Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Chinese Ministry of Education, Shihezi, Xinjiang, 832002, China
| | - Yangyang Zhang
- Department of Pathology, Shihezi University School of Medicine and The Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Chinese Ministry of Education, Shihezi, Xinjiang, 832002, China
| | - Xiaomeng Wang
- Department of Pathology, Shihezi University School of Medicine and The Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Chinese Ministry of Education, Shihezi, Xinjiang, 832002, China
| | - Qiaochu Zhang
- Department of Pathology, Shihezi University School of Medicine and The Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Chinese Ministry of Education, Shihezi, Xinjiang, 832002, China
| | - Yang Wang
- Department of Pathology, Shihezi University School of Medicine and The Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Chinese Ministry of Education, Shihezi, Xinjiang, 832002, China
| | - Chunxia Liu
- Department of Pathology, Shihezi University School of Medicine and The Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Chinese Ministry of Education, Shihezi, Xinjiang, 832002, China.
| | - Feng Li
- Department of Pathology, Shihezi University School of Medicine and The Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Chinese Ministry of Education, Shihezi, Xinjiang, 832002, China. .,Department of Pathology and Medical Research Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, People's Republic of China.
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Nangalia R, Shah N, Sheikh MA, Pal M. Rhabdomyosarcoma involving maxilla mimicking gingival enlargement: A diagnostic challenge. BMJ Case Rep 2019; 12:12/11/e230692. [PMID: 31776147 DOI: 10.1136/bcr-2019-230692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Rhabdomyosarcoma (RMS) is a rare, rapidly growing, highly aggressive malignant neoplasm, originating from undifferentiated mesenchymal cells that retain their ability to differentiate into skeletal muscle. It mainly affects children, accounts for <1% of all adult malignancies and has varied clinical presentations. The head and neck region accounts for 35%-40% of all RMS cases, of which 10%-12% cases involve the oral cavity. This report deals with a case of RMS in a 40-year-old woman, primarily involving maxillary gingiva for which she underwent excision with subsequent recurrences. The uniqueness of this case is that it reminds us of the essential clinical dictum that 'every growth we encounter, no matter how benign it appears clinically, should be looked upon with suspicion'. Hence, proper integration of history, clinical examination and investigation is required to reach a correct diagnosis enabling early treatment, thereby preventing functional and aesthetic loss and psychological trauma.
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Affiliation(s)
- Richa Nangalia
- Oral Pathology, Gurunanak Institute of Dental Science and Research, Kolkata, West Bengal, India
| | - Neha Shah
- Oral Pathology, Gurunanak Institute of Dental Science and Research, Kolkata, West Bengal, India
| | - Mahmud Abdul Sheikh
- Oral Pathology, Gurunanak Institute of Dental Science and Research, Kolkata, West Bengal, India
| | - Mousumi Pal
- Oral Pathology, Gurunanak Institute of Dental Science and Research, Kolkata, West Bengal, India
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Embryonal Rhabdomyosarcoma (Botryoid Subtype) Affecting the Buccal Mucosa. Head Neck Pathol 2018; 13:671-676. [PMID: 30094776 PMCID: PMC6854166 DOI: 10.1007/s12105-018-0957-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Abstract
Rhabdomyosarcoma (RMS) is a rare oral malignant soft tissue tumor whose pathological features may influence the clinical behavior, treatment and prognosis of the lesion. We report a case of a 13-year-old female patient, presenting an asymptomatic polypoid swelling in the left buccal mucosa that was approximately 2.5 cm in diameter and 3 months evolution. The presumptive diagnosis was fibrous hyperplasia and an excisional biopsy was carried out. Pathologic analysis revealed proliferation of predominantly ovoid cells, with eosinophilic cytoplasm and pleomorphic nuclei, arranged in subepithelial cambium layer. The mucosal surface presented a papillary-verrucous appearance. Immunohistochemical analysis revealed intense positivity for desmin, myogenin and Ki-67. The diagnosis was of embryonal RMS (botryoid variant). The patient was subjected to complementary chemotherapy and radiotherapy, with no evidence of recurrence or metastatic disease after 12 months follow-up. A discussion on the clinical, histopathological, immunohistochemical and therapeutic aspects of botryoid RMS will be provided.
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