Spindle cell rhabdomyosarcoma of the prostate

Abstract

The spindle cell rhabdomyosarcoma is a rare variant of the embryonal rhabdomyosarcoma, mostly occurring in childhood. Only a few cases are described in adults. To date, no case of the spindle cell subtype of the prostatic embryonal rhabdomyosarcoma has been published. We report on a 23‐year‐old man, initially presenting with obstructive micturition problems, perineal pain and night sweat. After diagnosis by transrectal biopsy of the prostate, radiochemotherapy within the CWS 2002 P study was applied: nine cycles of vincristine, doxorubicin, actinomycin D, ifosfamide, and fractionated radiotherapy of the tumor and suspect lymph nodes (final dose 50.4 Gy). The tumor initially shrank, but an early local recurrence arose. Second‐line chemotherapy was applied, followed by a salvage radical cytoprostatectomy. The patient died of disseminated disease 14 months after diagnosis.

Spindle cell embryonal rhabdomyosarcoma of the prostate in an adult patient – case report and review of clinicopathological features

“…A recently published review of the literature resulted in only 25 cases of confirmed primary ERMS of the prostate in males 18 years of age or older until October 2010 [ 20 ]. Since then, a literature search yielded five more cases of prostatic ERMS [ 9 , 12 , 13 , 21 , 22 ], resulting in a total of 30 published and confirmed primary ERMS of the prostate in adults. Of all published cases in adults so far, only three were specifically subtyped as spindle cell type of ERMS [ 9 , 13 , 22 ], thus, the case we present here is the fourth one published to date.…”

“…The histologic diagnosis of the spindle cell variant of ERMS is usually based on the presence of small, round to spindle-shaped tumor cells with moderate nuclear pleomorphism. Frequent findings are scattered large rhabdomyoblasts with an eccentric nucleus and striated, eosinophilic cytoplasm [ 9 , 10 ].…”

“…They found an association between histological tumor subtype and outcome: Rhabdomyosarcoma patients had worse overall and cancer-specific survival compared to leiomyosarcoma patients [ 26 ]. Latz et al [ 9 ] describe a case of spindle cell rhabdomyosarcoma of the prostate in a 23-year-old patient who died 14 month after diagnosis being treated within the CWS 2002 P study which includes children and adolescents with soft tissue sarcoma. They retrospectively criticize that early radical surgery was not performed in the first place but the patient received radiochemotherapy.…”

“…In contrast to infants and children prognosis is poor in this age group [ 7 – 13 ]. Spindle cell rhabdomyosarcoma is considered a rare variant of ERMS that shows spindle cell morphology [ 9 , 14 ]. In the latest WHO classification scheme spindle cell rhabdomyosarcoma is grouped together with sclerosing rhabdomyosarcoma [ 15 ].…”

Primary third ventricular tumor in an 18‐year‐old man

“…In a review of 18 adult cases, they most commonly arose in deep soft tissue of the head, neck and extremities rather than paratesticular region . Visceral cases, such as that of heart, prostate, uterus and retroperitoneum, have also been described.…”