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    Go to the top of the page   ID: 20101002024050 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    | The Authors | Discussion | Write a Comment to this Case |
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    Rhabdomyosarcoma
    Jerry Howard. Rhabdomyosarcoma. PedRad [serial online] vol 10, no. 10.
    URL: www.PedRad.info/?search=20101002024050


     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are CT-images available for this case. [ CT ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Jerry Howard (University of Missouri/Columbia/USA)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    2 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    Neck-Other and unknown  

     
     Pediatric Radiology CasesMost likely etiology:

    neoplastic  

     
     Pediatric Radiology CasesHistory:

    2 yo male presents to the ED with nausea and vomiting and altered mental status and a pre auricular mass. Chemistry analysis revealed marked hypercalcemia. KUB performed to evaluate for renal calculi which did not show any calculi. However, pelvis had several areas of mottling. CT head performed because of altered mental status and nausea/vomiting. A soft tissue mass noted in the right masticator space with intracranial extension via the foramen ovale. CT chest, abdomen, and pelvis was then performed which demonstrated diffuse axial skeletal lytic lesions.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    N/A  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Bilateral iliac bones and proximal femora have a subtle mottled appearance.





    CT 1 <- view CT 1

    CT 1: post IV contrast axial CT neck: Heterogeneous enhancing mass in the right masticator space.





    CT 2 <- view CT 2

    CT 2: IV contrast CT neck coronal reformats: Right masticator space widens and extends through the foramen ovale into the cavernous sinus/Meckel’s cave.





    CT 3 <- view CT 3

    CT 3: IV contrast CT neck coronal reformat:Right masticator space heterogeneous enhancing soft tissue mass which causings splaying of the internal and external carotid arteries.





    MRI 1 <- view MRI 1

    MRI 1: MRI axial T1 pre contrast : Right masticator space heterogeneous soft tissue signal intensity mass obliterates fat planes.





    MRI 2 <- view MRI 2

    MRI 2: MRI axial T1 post contrast: Right masticator space heterogeneously enhancing soft tissue signal intensity mass.





    MRI 3 <- view MRI 3

    MRI 3: MRI T2 coronal: right masticator space mass extends into right cavernous sinus/Meckel's cave via foramen ovale.



     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Dissection / Histo  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Peds: Lymphoma, Rhabdomyosarcoma, Metastatic disease (Neuroblastoma), Osteosarcoma, Ewing sarcoma, Schwannoma (V3), PNET

    Adolescents: Juvenile angiofibroma via pterygomaxillary fissure

    Adults: Minor salivary tumor or squamous cell carcinoma via extension from anterior buccal space; schwannoma and meningioma via foramen ovale. Intinsic masses: Malignant fibrous histiocytoma, fibrosarcoma, hemangiosarcoma, metastasis
     

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Over several months, the patient underwent several rounds of chemoradiation treatment with an excellent response.

    Rhabdomyosarcoma (RMS) is the most common pediatric soft tissue sarcoma, constituting 3-5% of all malignancies in childhood. In 40% of childhood cases of rhabdomyosarcoma, the tumor is located in the head/neck region, making only second to lymphoma. Other common sites RMS is found are genitourinary tract and extremities. RMS presents in a bimodal distribution between 2-4 years and 12-16 years.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    First case of rhabdomyosarcoma was described in 1854 by Webner in a young patient with tongue cancer. In 1946, Stout published a series of case reports of adults with rhabdomyosarcoma involving the trunk and limbs. Little over a decade later, in 1958, Horn and Enterline proposed a classification of the tumor into four subgroups: embryonal, alveolar, botryoid, and pleomorphic.  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Andrassy, R.; Hayes-Jordan, A.
    “Rhabdomyosarcoma in Children”
    Current Opinions in Pediatrics.

    2. Medline: Medline
    Wei, Y; Xia, J.
    “Masticator Space: CT and MRI of secondary Tumor Spread”
    American Journal of Roentgenology

    3. Medline: Medline
    Adam, R.; Balm, A.; Bras, J.
    "Imaging Findings in Craniofacial Childhood Rhabdomyosarcoma"
    Pediatric Radiology

    4. Medline: Medline
    Paidas, C; Rodeberg, D.
    "Childhood Rhabdomyosarcoma"
    Seminars in Pediatric Surgery  

     
     Pediatric Radiology CasesKeywords:

    rhabdomyosarkom, masticator space, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Jerry Howard. Rhabdomyosarcoma. PedRad [serial online] vol 10, no. 10.
    URL: www.PedRad.info/?search=20101002024050  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Neck-Other and unknown
    or in the region: Neck
    or in the tissue/organ: Other and unknown
    or with the etiology: neoplastic
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are CT-images available for this case. [ CT ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Rhabdomyosarcoma
    Jerry Howard. Rhabdomyosarcoma. PedRad [serial online] vol 10, no. 10.
    URL: www.PedRad.info/?search=20101002024050


     

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    Rhabdomyosarcoma
    Other cases by these authors:

    Search Jerry Howard in Medline Jerry Howard (1)   

    Rhabdomyosarcoma  
     
    Rhabdomyosarcoma
    Jerry Howard. Rhabdomyosarcoma. PedRad [serial online] vol 10, no. 10.
    URL: www.PedRad.info/?search=20101002024050


     

    Which diagnosis have other collegues guessed?


    • Lymphoma
      Votes: 4 (11 %)


    • Rhabdomyosarcoma
      Votes: 18 (52 %)


    • Metastatic disease (Neuroblastoma)
      Votes: 10 (29 %)


    • Osteosarcoma
      Votes: 1 (2 %)


    • Ewing sarcoma
      Votes: 1 (2 %)



        Total answers: 34

     
    Rhabdomyosarcoma
    Jerry Howard. Rhabdomyosarcoma. PedRad [serial online] vol 10, no. 10.
    URL: www.PedRad.info/?search=20101002024050


     

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    Rhabdomyosarcoma
    Jerry Howard. Rhabdomyosarcoma. PedRad [serial online] vol 10, no. 10.
    URL: www.PedRad.info/?search=20101002024050


     




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