Robotic cystprostatectomy in a 13-year-old child with prostate rhabdomyosarcoma

Abstract

Introduction. R Rhabdomyosarcoma is the most common type of sarcoma in children, which can affect the genitourinary system. Treatment protocols for patients with rhabdomyosarcomas of the prostate and bladder differ, particularly regarding the need, extent, and timing of surgical treatment. Currently, there are two main treatment protocols for rhabdomyosarcomas of the bladder and prostate: the European (SIOP), approved by the International Society of Pediatric Urology, and the North American one, supported by the Children's Oncology Group (COG). Both protocols share the use of neoadjuvant chemotherapy after biopsy of the lesion to clarify the diagnosis. However, the North American protocol recommends further radiotherapy to prevent dysfunction of pelvic organs after surgery, while the European protocol advocates for surgical correction after chemotherapy. Moreover, there is no unified approach to selecting the surgical treatment method. Specialists use both organ-preserving and organ-sparing operations. Objective. To describe a clinical case of using robotic cystoprostatectomy as a radical treatment method for a patient with prostate rhabdomyosarcoma. Clinical case. The paper describes a clinical case of a 13-year-old boy with prostate rhabdomyosarcoma who received staged chemotherapy and radiotherapy. Since residual tumor tissue remained, the child underwent radical surgery, including robotic cystoprostatectomy with the creation of bilateral ureterostomy. Conclusion. In this case, it was decided to opt for a radical surgical treatment method — cystoprostatectomy with removal of the bilateral ureterostomy. This decision was based on the presence of residual tumor tissue according to MRI data, as well as after numerous blocks of chemotherapy and radiotherapy. This approach allowed the patient to undergo an adjuvant course of chemotherapy without the risk of postoperative complications, such as infection of the intestinal reservoir in cases where it is created simultaneously with cystoprostatectomy.

Keywords

• rhabdomyosarcoma
• prostate
• bladder
• robotic cystprostatectomy
• oncology
• children