Rhabdomyosarcoma in Children: A Retrospective Analysis of 12 Cases

Objective This study aimed to describe the clinicopathological characteristics, immunohistochemical profile, treatment, and outcomes of 12 pediatric rhabdomyosarcoma (RMS) cases diagnosed at our institution and to compare our findings with those reported in the literature. Materials and methods The study involved a retrospective analysis of 12 cases of histologically confirmed RMS diagnosed between November 2018 and September 2025 at the Department of Anatomical Pathology at the Mohammed VI University Hospital Center in Oujda. Results The sex ratio was 1:1, and the median age at diagnosis was two years and six months. Children aged between one and five years represented eight cases (66.6%). Tumor size exceeded 5 cm in eight patients(66.6%). The most common anatomical location was the head and neck (non-parameningeal) region, accounting for three cases (25%), followed by the orbit, extremities, and bladder, with two cases each (16.7%). The genitourinary tract (excluding the bladder and prostate), abdomen, and trunk each represented one case (8.3%). Embryonal RMS was the predominant histological subtype, accounting for eight cases (66.6%), whereas alveolar RMS and the botryoid variant of embryonal RMS each represented two cases (16.7%). Risk stratification revealed an equal distribution among the four categories, each accounting for three cases (25%): low-risk subset 1, low-risk subset 2, intermediate risk, and high risk. All patients received chemotherapy, whereas five (41.7%) also underwent surgery, and six (50%) received radiotherapy. Conclusions RMS is the third most common pediatric tumor after neuroblastoma and nephroblastoma. Histopathological and immunohistochemical examinations remain essential for accurate diagnosis, tumor classification, and therapeutic decisions. Treatment relies on a multidisciplinary approach combining chemotherapy with surgery and/or radiotherapy based on risk stratification and other prognostic factors. Despite advances in management, RMS remains one of the most common pediatric soft tissue sarcomas and continues to represent a significant therapeutic challenge.