Childhood rhabdomyosarcoma. Anatomo-clinical and therapeutic study on 25 cases. Surgical implications

Vol. 54 No. 3 Suppl., 2013
This supplement was not sponsored by Outside Organizations.


Smaranda Diaconescu, M. Burlea, Ingrid Miron, S. G. Aprodu, Doina Mihaila, Claudia Olaru, L. Miron

Rhabdomyosarcomas (RMS) are the most frequent soft tissue sarcomas of childhood. Despite advances in knowledge about biological pathways of tumorigenesis, risk stratification and multimodal treatment, the immediate and long-term prognosis of these lesions in many countries with limited resources is still poor. Patients and Methods: Twenty-five histologically confirmed pediatric RMS were recorded during the period of study. Demography, clinical presentation, diagnostic means, pretreatment staging and post-surgical grouping, histological type, therapy and outcome were evaluated. Results: The mean age was 6.7 years; the group included 12 boys and 13 girls. Twelve lesions were localized in the genitourinary tract, eight in the trunk and extremities, two cases each in head and neck and retroperitoneum and one case in biliary tract. Primary surgical attempt was performed in 15 patients but only in nine of them underwent complete resection (three with free margins) other six cases achieving removal with residual disease. In 10 cases, solely biopsy was possible. Twenty-four patients received chemotherapy but only four cases performed radiation therapy. Overall survival rate was only 36% (nine cases). Conclusions: As mean feature children from our series had late presentation with locally extended (bulky and node positive) lesions and unfavorable sites. Improved multimodal management of RMS in recent years will probably lead to better survival curves in an increasing number of cases and an outstanding outcome in children with locally advanced disease.

Corresponding author: Sergiu Gabriel Aprodu, Associate Professor, MD, PhD; e-mail:

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B. Abu Juba, Alina Sovrea, Diana Crisan, Carmen Melincovici, A. Coneac, Mandra Badea, Maria Crisan

Cutaneous carcinomas are malignant lesions, which most commonly occur on photo-aggressed site. The purpose of our study was to evaluate the immunohistochemical expression of three apoptotic markers (p53, Bax, and Bcl-2) in photoinduced basal and squamous cell carcinoma. The study was performed on 24 patients diagnosed with these forms of cutaneous carcinoma localized on photoexposed regions: 14 cases of basal cell carcinoma (BCC) and 10 cases of squamous cell carcinoma (SCC), classified accordingly WHO 2003. The immunohistochemical study performed on the three proteins involved in the apoptotic process revealed certain specific features in their manner of expression, which do not correlate or respect the critical determinant rule (Bcl-2/Bax>1). Basal cell carcinoma expresses higher levels of Bcl-2, with a better prognosis, a less aggressive evolution, and no metastasis. Squamous cell carcinoma, on the other hand, expresses lower levels of Bcl-2, but the clinical outcome is more aggressive, the tumor has a faster evolution and may metastasize. P53 protein respects the profile given in literature data, having a higher score in squamous cell carcinoma versus basal cell carcinoma. According to the tumor localization on photo-aggressed sites, we have considered that ultraviolet rays play an important role in initiation of carcinogenesis through still occult mechanisms that may induce these particular or rather "bizarre" expressions of apoptotic markers.

Corresponding author: Alina Sovrea, Associate Professor, MD, PhD; e-mail:

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