Clinical Materials Analysis Of Sinonasal Rhabdomyosarcoma

Objectives The purposes of this paper were to analyze the characte-ristics of signs and symptoms of sinonasal rhabdomyosarcoma(RMS), to inves-tigate the values of radiology in clinical staging and preoperative evaluations of sinonasal RMS, and to discuss the meanings of immunohistochemistry and molecular biology in diagnosis, typing and prognostic evaluations of sinonasal RMS.Materials & Methods The study objects were 8 sinonasal RMS patients admission to our department between Dec.2000 and Dec.2010. General clini-cal materials(sex, age and durations before admission), signs and symptoms, auxiliary examinations(electronic nasopharyngoscope, CT, MRI and pathology), clinical staging, treatment and results were analyzed. Refered to related papers, we discussed the values of molecular biology in typing and prognostic evaluation of sinonasal RMS.Results Sexual ratio was 1:1. Age ranged from 8 years to 58 years and only one of the patients was child. The shortest duration before admission was 20 days and the longest one was 8 years. Two patients simply presented with nasal symptoms, five patients got ophthalmic abnormalities, one had cheek pain with tooth loss and anther one came to hospital because of cervical swelling and pain. With electronic nasopharyngoscope, the tumor was seen as purple mass or just like grey polypoid mass. On CT scan, sinonasal RMS was demonstrated as non-specific soft tissue. But bony erosions and calcifications in tumors were demonstrated well on CT. On MRI, sinonasal RMS was seen hyperintense or slightly hyperintense on T1-weighted and T2-weighted images, and the intension was uneven. With contrast, the lesions showed mild to moderate enhancement, it's also uneven. Compared with CT scan, MRI demonstrated the involvement of normal tissues very well. Most of the cases were exactly diagnosed with immunohistochemistry while some cases were diagnosed and typed depending on cellular morphology. Two of the eight cases were at stageâ…£and the other five cases were stageâ…¢. All cases received surgery. Two cases'follow-up visits were lost. One patient had a accident and died during recovery after operation. One case received chemotherapy after operation, but was found metastases in cervical vertebrae two months later and died five months after operation. There was one patient received full-term radiotherapy after operation, but was found extensive abdominal metastases when radiotherapy was completed and died three months later. One case didn't receive radiotherapy or chemotherapy and she was found metastases in cervical and axillary lymph nodes. Because the lesions were too extensive, one patient had to give up following treatment and died three months later. Another case was not able to complete the chemo-therapy, later he was found extensive cervical and pharyngeal metastases and died four months later after operation.Conclusions 1) Sinonasal RMS can hardly be diagnosed in early stages, most patients are stageâ…¢or stageâ…£when they are present in hospital.2) CT combined with MRI can provide reliable staging and preoperative evaluations for sinonasal RMS.3) Immunochemistry and molecular biology are great meaningful for diagnosis, typing and prognostic evaluations of sinonasal RMS.