Challenges in the management of advanced rhabdomyosarcoma of the shoulder in a teenage boy: A case report.

INTRODUCTION AND IMPORTANCE: Delayed presentation and advanced-stage diagnosis of soft-tissue malignancies such as rhabdomyosarcoma remain major challenges in low-resource settings, often resulting in poor outcomes and complex management needs. CASE PRESENTATION: We report the case of a 19-year-old Tanzanian male with advanced rhabdomyosarcoma of the right upper limb. Limited health literacy, cultural beliefs, and economic constraints delayed his initial presentation. Despite early care at a regional facility, poor referral processes and inability to afford imaging led to a one-year delay in definitive treatment. He ultimately presented with a large, ulcerated, maggot-infested tumor requiring shoulder disarticulation and forequarter amputation. Recurrent wound infections necessitated prolonged antibiotic use, raising concerns about antimicrobial resistance. CLINICAL DISCUSSION: This case highlights multifactorial barriers to timely cancer care, including sociocultural factors, financial limitations, and weak referral systems. The advanced presentation necessitated radical surgery, which could have been avoided with early detection. The case underscores the importance of cancer awareness programs, improved referral pathways, and antimicrobial stewardship in chronic cancer care. CONCLUSION: This case emphasizes the urgent need for community-based cancer awareness, streamlined referral pathways, and affordable diagnostic strategies in low-resource settings. Improving early detection, strengthening health education, and integrating antimicrobial stewardship can reduce delays, improve outcomes, and alleviate healthcare burdens for patients with advanced malignancies.