How is pediatric rhabdomyosarcoma (RMS) diagnosed?

Updated: Mar 28, 2019
  • Author: Roshni Dasgupta, MD, MPH; Chief Editor: Eugene S Kim, MD, FACS, FAAP  more...
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Answer

Preoperative laboratory analysis is essential for any patient undergoing surgical treatment of rhabdomyosarcoma (RMS). Imaging is also required for operative management. Metastatic disease is evaluated through bone marrow analysis; bone scanning; computed tomography (CT) of the brain, lungs, and liver; and cerebrospinal fluid (CSF) analysis. Positron emission tomography (PET) may be included in the workup of a patient with RMS to evaluate occult metastases and regional adenopathy.

Any child with a suspected RMS requires confirmation by tissue diagnosis as well as surgical staging, including evaluation of regional lymph nodes at the time of surgery (depending on the location of the tumor). Thus, early surgical consultation is mandatory. The surgeon then helps determine, on the basis of the location and stage of the tumor, how best to proceed. Although the recommendation for lymph node biopsy has existed since 2003, surgical compliance with protocols regarding nodal excision has been poor, and this has affected patient outcome and overall survival. [24]


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