CLINICAL CASE OF A CHILD WITH RHABDO- MYOSARCOMA (RMS), EMBRYONIC TYPE, WITH ORAL COMPLICATIONS POST RADIATION THERAPY AND CHEMOTHERAPY

Case of a 7 years old female, with significant medical history of embrional type of RMS, diagnosed 2,5 years ago in left parapharingeal area. After surgical removal of the tumor, the area is radiated with 50Gy for 6 weeks and also has 3 courses of chemotherapy. By now the child is clinically healthy of RMS, but she has developed serious side effects of radiation therapy: erosive caries to all primary teeth, hyposalivation and total lost of function of the left parotid gland, delayed development of the teeth, facial asymmetry, caused by the arrested growth of left side mandibule. Acute and chronic complications of radiation therapy act to the dynamic changes of the oral environment in a phase of active growth, dental eruptions and incomplete mineralization. The potential risk of osteoradionecrosis and radiation caries, resulted in the sequel of xerostomia and a cariogenic shift in micro flora, requires a prophylactic and heeling program to modulate the oral environment and to prevent or at lease, minimize the side effects and should be integral part of the treatment. Frequent dental follow – up should be scheduled throughout the treatment period to reinforce the importance of continued oral hygiene and to deal with the complications for a lifelong period of time. Key word: Rhabdomyosarcoma (RMS) embryonic, alveolar RMS, and pleomorphic RMS, chemotherapy, radiation therapy, risk- oral environment, radiation caries, osteoradionecroses, salivary flow