Gastric Epithelioid Rhabdomyosarcoma: A Case Report

Epithelioid rhabdomyosarcoma is an uncommon tumor. It is found mainly in somatic soft tissues like parotid, urinary bladder, trunk, neck, and limbs. Only two cases of this tumor in gastrointestinal tract (liver and gastro esophageal junction) has been reported to date; thus, we herein reported an unusual site of this tumor in the pylorus part of the stomach. In the present paper, we studied a 67-year-old male subject with complaint of dyspepsia, belching, and reflux for about 4 years. He had also consumed herbal drugs to relieve the pain for several years. In the endoscopy procedure, there was a large tumor at the distal part of the gaster. Furthermore, excisional biopsy was performed and the histological specimens showed tumor necrosis with high mitotic cell counts, large vesicles, eosinophilic cytoplasm of epithelial cells, and round nuclei. Immunohistochemistry staining was positive for Myogenin, Desmin, MyoD1 (30% ratio), and Ki67 (70 % ratio). Computed tomography scan images showed several metastases to peritoneum and lungs. After initiating the treatment, the adverse effects of chemotherapy persuaded us to discontinue the regimen. Finally, the patient died due to pulmonary embolism. To conclude, primary epithelioid rhabdomyosarcoma is a very rare lethal cancer that may be found as gastrointestinal cancers. Hence, it requires further diagnostic investigations in order for the best treatment to be found.