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Case Reports: Rare disease
Left cheek sclerosing rhabdomyosarcoma and development of isolated free flap donor site metastasis
  1. Deborah Zhou1,
  2. Vivek Bhadri1,2,
  3. Peter Luk3,
  4. Sydney Ch’ng2,4,
  5. Daniel Franks5 and
  6. Angela Hong2,6
  1. 1Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
  2. 2The University of Sydney, Sydney, New South Wales, Australia
  3. 3Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
  4. 4Department of Head and Neck Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
  5. 5Department of Orthopaedics Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
  6. 6Department of Radiation Oncology, Chris O’Brien Lifehouse, Camperdown, New South Wales, Australia
  1. Correspondence to Dr Angela Hong; angela.hong{at}sydney.edu.au

Abstract

Rhabdomyosarcoma is a rare mesenchymal malignancy with four different morphological subtypes: alveolar, embryonal, pleomorphic and spindle cell/sclerosing. It is the most common soft tissue sarcoma of children and adolescents but occurs less commonly in adults. We describe a male patient in his 20s with sclerosing rhabdomyosarcoma of the left cheek who developed an isolated free flap donor site metastasis in the first instance but subsequently progressed with bilateral pulmonary metastases. Multidisciplinary team involvement in a sarcoma specialist centre is essential and collaboration between the pathologist, radiologist, head and neck surgeon, orthopaedic surgeon, radiation oncologist and medical oncologist were integral in providing optimal management in this patient. Furthermore, this case report highlights this phenomenon of implantation metastasis in a patient with rhabdomyosarcoma, and emphasises the importance of surgical barriers between the resection and reconstruction teams in an oncological case.

  • Oncology
  • Surgical oncology

https://doi.org/10.1136/bcr-2021-248390

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    Footnotes

    • Twitter @angelahong

    • Contributors DZ, AH contributed to concept and design. DZ contributed to literature search. DZ, AH, SC, DF, VB, PL contributed to data collection. DZ contributed to preparation of the first draft. DZ, AH, SC, DF, VB, PL contributed to review and approval of the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests AH received consultancy fee from Bayer, Provectus and Q Biotics.

    • Provenance and peer review Not commissioned; externally peer reviewed.