Giant metastasis of the thenar eminence revealing ovarian rhabdomyosarcoma

Karima Oualla, Nawfel Mellas

PAMJ. 2020; 36:96. Published 15 Jun 2020 | doi:10.11604/pamj.2020.36.96.23023

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.
Corresponding author
Karima Oualla, Medical Oncology Department, Hassan II University Hospital, Casablanca, Morocco (karimarauf@hotmail.com)

This image

Articles published in PAMJ are Open Access and distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0).

eISSN: 1937-8688


The Pan African Medical Journal (ISSN: 1937-8688) is a subsidiary of the Pan African Medical Journal. The contents of this journal is intended exclusively for professionals in the medical, paramedical and public health and other health sectors.

Currently tracked by: DOAJ, AIM, Google Scholar, AJOL, EBSCO, Scopus, Embase, IC, HINARI, Global Health, PubMed Central, PubMed/Medline, ESCI

Physical address: Kenya: 3rd Floor, Park Suite Building, Parkland Road, Nairobi. PoBox 38583-00100, tel: +254 (0)20-520-4356 | Cameroon: Immeuble TechnoPark Essos, Yaounde, PoBox: 10020 Yaounde, tel: +237 (0)24-309-5880