NAME THAT GROWTH!

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NAME THAT GROWTH!

• Joel Thompson, MSIII

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A (Brief) History

• 3 yo Male with a lump on his right calf
  discovered by his mother
• Differential?
• Hematoma (traumatic)
• Infectious
• Neoplastic

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T1 Axial
STIR Sag
T2 Axial
16.8 mm x 8.6 mm x 33.3 mm
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The Answer is

• Alveolar rhabdomyosarcoma
• Pt underwent wide excision with right femoral
  lymph node dissection
• Adjuvant chemo with ifosfamide/etoposide

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Rhabdomyosarcoma (RMS)

• ½ of all soft tissue tumor of childhood 3-4
  of pediatric cancers overall
• Overall incidence in population lt20 yo is 4.9
  cases per million people
• Can present in head and neck, GU tract, or
  extremities
• Has been associated with neuro-fibromatosis,
  Li-Fraumeni syndrome, Beckwith-Wiedemann
  syndrome, and Costello syndrome
• Histologic types include embyronal, alveolar,
  anaplastic, and undifferentiated

Okcu MF et. al. Rhabdomyosarcoma and
undifferentiated sarcoma in childhood and
adolescence. Uptodate.com. Accessed November
5, 2008.
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Rhabdomyosarcoma

• Imaging
• Plain films and CT of affected and surrounding
  areas
• MRI is becoming imaging study of choice because
  of ability to attenuate bone artifact and
  superior soft tissue contrast
• Basic metastatic work-up should include chest CT
  and bone scan
• Investigate positive findings on bone scan with
  plain film and MRI (if plain film is equivical)

Okcu MF et. al. Rhabdomyosarcoma and
undifferentiated sarcoma in childhood and
adolescence. Uptodate.com. Accessed November
5, 2008.