What are the signs and symptoms of rhabdomyosarcoma?

Updated: Feb 01, 2019
  • Author: Amelia F Drake, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

Rhabdomyosarcoma is a disease that can be diagnosed and treated early. Researchers in the IRS-IV reported that 23% of the patients received a diagnosed early enough to receive complete surgical resection, and 15% underwent gross resection with only microscopic residual disease.

Because of the various anatomic constraints of the head and neck, most lesions in this region are obvious at presentation; therefore, they are easily detected. A mass or area of localized swelling usually characterizes the initial presentation. Fewer than half of these patients present with pain.

Other symptoms, which depend on the location of tumor, include nasal discharge or airway obstruction, otorrhea, hearing loss, fetor (foul smell), and rapid proptosis. Cranial nerve palsies or other neurologic deficits indicate extension of the neoplasm into the skull base or CNS. The orbit is involved in nearly one third of head and neck rhabdomyosarcomas, followed by those in the oral cavity and oropharynx (29%), face and neck (24%), and middle ear and/or mastoid and sinonasal cavity (9%). Parameningeal sites include the paranasal sinuses, nasal cavity, and middle ear; rhabdomyosarcomas at these sites are observed in 16% of patients (see the images below).

Axial CT scan of rhabdomyosarcoma in the left midd Axial CT scan of rhabdomyosarcoma in the left middle ear. Image provided by Suresh Muhkerji, MD, Department of Radiology, University of North Carolina Hospitals.
Axial CT scan of left orbital rhabdomyosarcoma. Im Axial CT scan of left orbital rhabdomyosarcoma. Image provided by Suresh Muhkerji, MD, Department of Radiology, University of North Carolina Hospitals.
Axial CT scan of right masticator space rhabdomyos Axial CT scan of right masticator space rhabdomyosarcoma. Image provided by Suresh Muhkerji, MD, Department of Radiology, University of North Carolina Hospitals.
MRI of right masticator space rhabdomyosarcoma. Im MRI of right masticator space rhabdomyosarcoma. Image provided by Suresh Muhkerji, MD, Department of Radiology, University of North Carolina Hospitals.

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