| Objective: The clinical information of 18 patients with rhabdomyosarcoma of head and neck was reviewed,and their clinical,imaging characteristics,treatment methods and prognostic factors were discussed,so as to provide some experience for the clinical treatment of this disease.Methods: The clinical data of 18 patients with rhabdomyosarcoma of the head and neck admitted to our hospital from January 2011 to January 2019 were reviewed,and their clinical,imaging characteristics,treatment and prognosis were analyzed.All the selected patients were confirmed by pathology.Results: Among the 18 patients,the ratio of male to female was 5:13,with the age ranging from 1 month to 53 years old,and the median age was 8.5 years old.6 cases were primary in cheek(2 cases in parotid masseter region,2 cases in temporal region,2 cases in buccal region),6 cases in nose and throat(2 cases in nasal cavity,1 case in sinuses,2 cases in throat),3 cases in neck,1 case in orbit,1 case in soft palate and 1 case in scalp.The 14 cases presented with a progressively enlarged solitary mass.Color doppler ultrasound in 7 cases indicated uneven low to medium low echo mass and abundant blood flow signals.CT showed soft tissue density in 17 cases,12 of whom invaded adjacent tissues and surrounding bone.MRI in 9cases indicated that T1 WI presented isometric and slightly lower signals,and T2 WI presented isometric and slightly longer signals.In 5 cases,uniform or non-uniform enhancement was observed after CT or MRI enhancement.All the patients were examined by histopathology.There were 14 cases of embryonal type,3 cases of acinar type and 1 case of spindle cell type.According to Intergroup Rhabdomyosarcoma Study Group(IRS)staging system:stage?had 2 cases,stage ? 6 cases,stage ? 7 cases and ? 3 cases.Among these cases,2 cases were in the low risk group,13 cases in the medium risk group and 3 cases in the high risk group.Among the 18 patients,11 cases had complete resection and 7 cases had incomplete resection.After surgery,2 patients received chemotherapy and 10 patients received chemotherapy plus radiotherapy.The patients were followed up to January 2020 for 15-85 months,with a median survival time of 19 months.The results of single-factor analysis showed that the 2-year cumulative survival rate of the patients who received combined surgery,chemotherapy or radiotherapy was higher than that of the patients who only received surgery,and thedifference was statistically significant(P < 0.05).There was no statistically significant difference in the 2-year cumulative survival rate between patients with complete tumor resection and those without complete tumor resection(P >0.05).Among the 17 patients followed up,12 patients had local recurrence after surgery,with a local recurrence rate of70.6%(12/17).10 patients survived,5 patients died of local recurrence,and 2 patients died of bone and lung metastasis.1 patient was lost to follow-up.Conclusion: Rhabdomyosarcoma of the head and neck is rare and occurs in children and adolescents.It is common in the cheeks and nasopharynx.The pathological types were mostly embryonal.Due to the hidden location of the disease and unclear boundaries,extensive resection is not recommended.Surgical resection alone has poor efficacy and high local recurrence rate,the combination of surgery,chemotherapy or radiotherapy is the main factor to improve the prognosis of patients. |
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