{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:17:08Z","timestamp":1787019428495,"version":"build-2736575974"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine High Impact Case Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Paratesticular rhabdomyosarcoma (RMS) is a rare malignancy, representing ~3% of all pediatric soft tissue tumors. The spindle cell subtype, a variant of embryonal RMS, is particularly uncommon but is typically associated with a favorable prognosis. We report the case of a 12-year-old boy who presented with a painless, progressively enlarging right inguinoscrotal mass. Imaging studies revealed a heterogeneous lesion without distant metastasis, and tumor markers were within normal limits. The patient underwent radical orchiectomy, and histopathology confirmed spindle cell RMS, with immunohistochemical positivity for myogenin and desmin. After completing treatment with the Children\u2019s Oncology Group (COG)-ARST0531 Vincristine, Actinomycin D, and Cyclophosphamide protocol, a retroperitoneal lymph node recurrence was detected 1\u2009year later. Management consisted of surgical resection and escalated chemotherapy per the COG-ARST0431 protocol, with subsequent imaging showing no evidence of disease. This case demonstrates that despite a favorable histology, paratesticular spindle cell RMS carries a risk of late, regional recurrence, underscoring the necessity of vigilant long-term surveillance. We also performed a systematic literature review to contextualize our findings, focusing on clinical presentation, therapeutic strategies, and outcomes.<\/jats:p>","DOI":"10.1177\/23247096251415447","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T08:36:48Z","timestamp":1769848608000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["A Rare Pediatric Paratesticular Spindle Cell Rhabdomyosarcoma and Systematic Literature Review"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0532-151X","authenticated-orcid":false,"given":"Gevara","family":"Arja","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Palestine Polytechnic University, Hebron, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0626-1928","authenticated-orcid":false,"given":"Omar Hammam","family":"Salloum","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Palestine Polytechnic University, Hebron, Palestine"},{"name":"Palestinian Clinical Research Center, Bethlehem, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamal","family":"Jaber","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Palestine Polytechnic University, Hebron, Palestine"},{"name":"Department of Urology, Governmental Hebron Hospital, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tala","family":"Jubah","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Palestine Polytechnic University, Hebron, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumaya","family":"Alrjoub","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Palestine Polytechnic University, Hebron, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taghreed","family":"Imran","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Palestine Polytechnic University, Hebron, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asma","family":"Alrjoub","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Palestine Polytechnic University, Hebron, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ammar W.M.","family":"Hassouneh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Palestine Polytechnic University, Hebron, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motaz","family":"Natsheh","sequence":"additional","affiliation":[{"name":"Department of Pathology, Al-Ahli Hospital, Hebron, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,31]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-7-93"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15215269"},{"key":"e_1_3_3_4_2","first-page":"60","article-title":"Paratesticular adult rhabdomyosarcoma: a case report and review of literature","volume":"22","author":"Mokrani A","year":"2019","unstructured":"Mokrani A, Guermazi F, Meddeb K, et al. Paratesticular adult rhabdomyosarcoma: a case report and review of literature. Urol Case Rep. 2019;22:60-61.","journal-title":"Urol Case Rep"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/MS9.0000000000000461"},{"issue":"10","key":"e_1_3_3_6_2","article-title":"A rare case of paratesticular sarcoma: a case report","volume":"14","author":"Nunes NA","year":"2022","unstructured":"Nunes NA, Shah AA, Murugan G. A rare case of paratesticular sarcoma: a case report. 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