Robotic-assisted surgery approach in a biliary rhabdomyosarcoma misdiagnosed as choledochal cyst.
Rhabdomyosarcoma is a soft tissue malignant tumor affecting 1% of children from 0 to 14 years. Preoperative imaging may not always be diagnostic for hepatobiliary rhabdomyosarcoma and differential diagnosis with choledochal cyst (CC) could be difficult. We report a case of 2-years-old girl with a strange CC pattern of presentation. A grapelike lesion involving the choledochal and biliary ducts was easily and completely resected by robotic assisted surgery. Since no previous reports were available about oncologic safety of robotic approach, the porto-enterostomy was performed in open surgery. On histologic examination, the specimen revealed a botryoidembryonal rhabdomyosarcoma affecting both the common bile duct and the common hepatic duct. One year postoperatively the child is safe of tumor relapse. Robotic approach seems to be safe and advantageous to obtain a radical excision of the tumor at the porta hepatis, even in case of misdiagnosed malignant lesion mimicking a CC.
Department of the Mother and Child Health, Pediatric Surgery Unit, IRCCS Policlinico San Matteo Foundation and University of Pavia , Turin, Italy.
Ghassan
G
Nakib
Department of Internal Medicine, University of Pavia , Turin, Italy ; Department of the Mother and Child Health, Pediatric Unit, IRCCS Policlinico San Matteo Foundation , Turin, Italy.
Valeria
V
Calcaterra
Department of the Mother and Child Health, Pediatric Surgery Unit, IRCCS Policlinico San Matteo Foundation and University of Pavia , Turin, Italy.
Ilaria
I
Goruppi
Department of the Mother and Child Health, Pediatric Surgery Unit, IRCCS Policlinico San Matteo Foundation and University of Pavia , Turin, Italy.
Piero
P
Romano
Department of the Mother and Child Health, Pediatric Surgery Unit, IRCCS Policlinico San Matteo Foundation and University of Pavia , Turin, Italy.
Alessandro
A
Raffaele
Clinic of General Paediatric Surgery, Children's Hospital Regina Margherita, Citta della Salute e Scienza , Turin, Italy.
Jurgen
J
Schleef
Department of the Mother and Child Health, Pediatric Surgery Unit, IRCCS Policlinico San Matteo Foundation and University of Pavia , Turin, Italy.
Gloria
G
Pelizzo
biliary botryoid rhabdomyosarcoma; choledochal cyst; porta hepatis; robotic surgery