Images in clinical medicine | Volume 36, Article 96, 15 Jun 2020 | 10.11604/pamj.2020.36.96.23023

Giant metastasis of the thenar eminence revealing ovarian rhabdomyosarcoma

Karima Oualla, Nawfel Mellas

Corresponding author: Karima Oualla, Medical Oncology Department, Hassan II University Hospital, Casablanca, Morocco

Received: 22 Apr 2020 - Accepted: 26 Apr 2020 - Published: 15 Jun 2020

Domain: Oncology

Keywords: Ovary, rhabdomyosarcoma, thenar, metastasis

©Karima Oualla et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Karima Oualla et al. Giant metastasis of the thenar eminence revealing ovarian rhabdomyosarcoma. Pan African Medical Journal. 2020;36:96. [doi: 10.11604/pamj.2020.36.96.23023]

Available online at: https://www.panafrican-med-journal.com/content/article/36/96/full

Home | Volume 36 | Article number 96

Images in clinical medicine

Giant metastasis of the thenar eminence revealing ovarian rhabdomyosarcoma

Giant metastasis of the thenar eminence revealing ovarian rhabdomyosarcoma

Karima Oualla1,2,&, Nawfel Mellas1,2

 

1Medical Oncology Department, Hassan II University Hospital, Casablanca, Morocco, 2Medical Oncology Department, Sidi Mohamed Ben Abdellah University, Fes, Morocco

 

 

&Corresponding author
Karima Oualla, Medical Oncology Department, Hassan II University Hospital, Casablanca, Morocco

 

 

Image in medicine    Down

Ovarian rhabdomyosarcoma is extremly rare and the diagnosis might be a real dilemma clinically and histologically. We report here the case of a 19-year-old patient, who presented a progressive increase of the abdominal volume associated with dyspnea and general conditions deterioration. The pelvic MRI showed bilateral ovarian masses associated with peritoneal carcinomatosis. CA125 was elevated (273u/ml) while other markers including bHCG, inhibine, AFP were normal. Simultaneously, the patient developed a cutaneous lesion in the thenar's lodge of the right hand rapidly increasing volume, painful and necrotic. The MRI of the right hand showed a large necrotic tissue mass of the right thenarian lodge without bone involvement which may correspond to a secondary localization. Cutaneous biopsy was performed and revealed a skin localization of undifferentiated malignant tumour and IHC analysis were compatible with alveolar rhabdomyosarcoma. After these findings, an exploratory laparotomy was performed and revealed the presence of two bilateral ovarian masses with ascites of great abundance and large dissemination of carcinomatosis nodules. Several biopsies were performed and the histological analysis with IHC have confirmed the diagnosis of ovarian rhabdomyosarcoma (desmin, myogenin, myoD1 were positive). The patient received chemotherapy based on: vincristine, adriamycin and cyclophosphamide with peritoneal and thenar progression after 6 cycles. Patient refused hand amputation and was proposed for radiotherapy. A second line chemotherapy with etoposide and ifosfamide was established.

 

Figure 1: giant metastasis of the thenar eminence revealing ovarian rhabdomyosarcoma

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Images in clinical medicine

Giant metastasis of the thenar eminence revealing ovarian rhabdomyosarcoma

Images in clinical medicine

Giant metastasis of the thenar eminence revealing ovarian rhabdomyosarcoma

Images in clinical medicine

Giant metastasis of the thenar eminence revealing ovarian rhabdomyosarcoma

Volume 36 (May - Aug 2020)
This article authors
On Pubmed
On Google Scholar
Citation [Download]
EndNote
Reference Manager
Zotero
BibTex
ProCite

Navigate this article
Key words

Ovary

Rhabdomyosarcoma

Thenar

Metastasis

PlumX Metrics
Giant metastasis of the thenar eminence revealing ovarian rhabdomyosarcoma