Rhabdomyosarcoma with initial pancreatic metastasis: a case report

Abstract

Background: Pancreatic metastasis, particularly as the primary site of metastasis in rhabdomyosarcoma (RMS), is exceedingly rare, leading to a lack of relevant literature and research studies due to its extreme rarity. Moreover, its clinical presentation closely mimics pancreatitis, posing significant challenges in early clinical detection and diagnosis. Case demonstration: A 44-year-old male patient with a history of RMS originating from the right paranasal sinus underwent regular postoperative chemoradiotherapy. He presented to our gastroenterology department with complaints of abdominal pain and lower back pain for one month. Subsequent auxiliary examinations, including ultrasound gastroscopy and positron emission tomography-computed tomography (PET-CT) scans, suggest the possibility of pancreatitis or tumor metastasis. Eventually, a pancreatic puncture biopsy confirmed RMS with pancreatic metastasis. Following diagnosis, the patient was transferred to the Cancer Hospital for scheduled chemoradiotherapy. During an 8-month follow-up, the patient exhibited no evidence of metastasis to organs other than the pancreas and survived. Conclusions:Historically considered an advanced condition precluding surgical intervention, the reported instance of metastatic RMS to the pancreas demonstrates the potential for improved survival and quality of life with timely surgical and adjunctive therapies contingent upon early detection, diagnosis, and treatment. Given the clinical resemblance to pancreatitis, definitive diagnosis relies heavily on pathological biopsy. Therefore, more cases warrant collection for a comprehensive investigation into the clinical, pathological, and genetic characteristics of this rare condition.