title: Prostate embryonal rhabdomyosarcoma in adults: Case report and review of literature.
abstract: BACKGROUND
  Prostate embryonal rhabdomyosarcoma (ERMS) is a common tumour in infants and children, with a median occurrence age of 5 years, but it is rare in adults. It is characterized by a high degree of malignancy, both local rapid growth with formation of large pelvic masses, often leading to renal failure due to urethral obstruction, and systemic spread, commonly to the lungs, liver and bone. Several therapeutic approaches have been employed in the effort to treat prostate ERMS, but all of them have failed to gain a significant survival benefit in adult patients.
  
  
  METHODS
  We report on a case of a stage IV prostate ERMS, approached with combined-modality treatment, with the administration of 5 courses of doxorubicin, ifosfamide and 2-mercaptoethane sulfonate sodium (mesna), and, subsequent radiotherapy to the prostatic bed (60 Gy/30 fxs). The patient remained free of progression of disease for about 1 year to finally experience a systemic relapse with multiple lung metastases and pleural effusion. The patient died for metastatic disease 27 months following the initial diagnosis.
  
  
  CONCLUSIONS
  While it remains questionable which therapeutic approach for prostate ERMS in adults is the most appropriate, our report demonstrates that a chemo-radiation combined treatment can control the prostate disease, reducing the symptoms and improving the quality of life of these patients, for the most part destined to die for systemic progression of disease.
authors.affiliation: Radiation Therapy Unit, Department of Oncology and Advanced Technology, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Viale Risorgimento 80, 42121, Reggio Emilia, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Ciammella
authors.affiliation: Radiation Therapy Unit, Department of Oncology and Advanced Technology, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Viale Risorgimento 80, 42121, Reggio Emilia, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Galeandro
authors.affiliation: Radiation Therapy Unit, Department of Oncology and Advanced Technology, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Viale Risorgimento 80, 42121, Reggio Emilia, Italy.
authors.forename: Nunziata
authors.initials: N
authors.lastname: D'Abbiero
authors.affiliation: Radiation Therapy Unit, Department of Oncology and Advanced Technology, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Viale Risorgimento 80, 42121, Reggio Emilia, Italy.
authors.forename: Tamara
authors.initials: T
authors.lastname: Palmieri
authors.affiliation: Radiation Therapy Unit, Department of Oncology and Advanced Technology, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Viale Risorgimento 80, 42121, Reggio Emilia, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Donini
authors.affiliation: Radiation Therapy Unit, Department of Oncology and Advanced Technology, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Viale Risorgimento 80, 42121, Reggio Emilia, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Iotti
keywords: Adults; Embrional; Prostate cancer; Radiation therapy; Rhabdomyosarcoma