title: Clinical Management of Orbital Rhabdomyosarcoma in a Referral Center in Spain.
abstract: OBJECTIVE
  To review the systemic and ocular outcomes and long-term status of ocular rhabdomyosarcoma in pediatric patients in a tertiary center in Spain.
  
  
  METHODS
  All patients younger than 18 years who were diagnosed as having ocular rhabdomyosarcoma and treated between 1982 and 2011 at La Paz University Hospital, Madrid, Spain, were included. Clinical presentation, management, complications, and ocular and systemic outcomes were reviewed.
  
  
  RESULTS
  The mean age at presentation was 8 years (range: 3 months to 12.5 years). In all cases, the rhabdomyosarcoma was located primarily in the orbit. Treatment included surgical debulking and various regimens of chemotherapy and radiotherapy. All of the patients underwent surgical biopsy for diagnosis confirmation. Orbital exenteration was performed in 4 cases (28%). Twelve patients received radiotherapy. The long-term visual outcomes of the 10 patients who maintained their globe was as follows: best corrected visual acuity 20/20 to 20/40 in 6 patients (60%), 20/50 to 20/100 in 2 patients (20%), and 20/200 to no light perception in 2 patients (20%). Intraocular complications (primarily cataracts: 50%) were present in 7 patients (70%), ocular surface lesions occurred in 6 patients (60%), and orbital sequelae were found in 8 patients (80%). Local tumor recurrence was detected in 5 patients (35%) and distant metastasis occurred in 2 patients (14%). Tumor-related death occurred in 1 patient (7%).
  
  
  CONCLUSIONS
  Orbital rhabdomyosarcoma has an excellent prognosis; nevertheless, local complications are common, including surgery-related complications. To minimize them, initial surgical planning based on individual patient characteristics and an accurate diagnosis of relapses is mandatory. The clinical presentation, management, and long-term ocular and systemic outcomes are comparable with other series published to date.
authors.forename: Luciano
authors.initials: L
authors.lastname: Bravo-Ljubetic
authors.forename: Jesús
authors.initials: J
authors.lastname: Peralta-Calvo
authors.forename: Paula
authors.initials: P
authors.lastname: Larrañaga-Fragoso
authors.forename: Nuria Olivier
authors.initials: NO
authors.lastname: Pascual
authors.forename: Natalia
authors.initials: N
authors.lastname: Pastora-Salvador
authors.forename: Jose Abelairas
authors.initials: JA
authors.lastname: Gomez
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005094:Exophthalmos / Q000175:diagnosis; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D013508:Ophthalmologic Surgical Procedures; D009918:Orbital Neoplasms / Q000175:diagnosis / Q000628:therapy*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000175:diagnosis / Q000628:therapy*; D013030:Spain; D062606:Tertiary Care Centers
chemical_list: D000970:Antineoplastic Agents