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Rhabdomyosarcoma

Rhabdomyosarcoma is a cancerous (malignant) tumor of the muscles that are attached to the bones.

It can occur in many places in the body. The most common sites are the head and neck, the urogenital tract, and the arms or legs.

Alternative Names

Soft tissue sarcoma; Alveolar rhabdomyosarcoma; Embryonal rhabdomyosarcoma; Sarcoma botryoides

Causes

Rhabdomyosarcoma is the most common soft tissue tumor in children.

The cause of rhabdomyosarcoma is unknown. It is a rare tumor with only several hundred new cases per year in the United States.

Some children with certain birth defects are at an increased risk. Some families have a gene mutation that increases this risk. Most children with rhabdomyosarcoma do not have any known risk factors.

Symptoms

The most common symptom is a mass that may or may not be painful.

Other symptoms vary depending on location of the tumor:

  • Tumors in the nose or throat may cause bleeding, congestion, swallowing problems, or neurological problems if they extend into the brain.
  • Tumors around the eyes may cause bulging of the eye, problems with vision, swelling around the eye, or pain.
  • Tumors in the ears, may cause pain, hearing loss, or swelling.
  • Bladder and vaginal tumors may cause lead to trouble starting to urinate or having a bowel movement, or poor control of urine.
  • Muscle tumors may lead to a painful lump, and are often thought to be an injury.

Exams and Tests

Diagnosis of rhabdomyosarcoma is often delayed because of lack of symptoms and because the tumor may appear at the same time as a recent injury. Early diagnosis is important because rhabdomyosarcoma spreads quickly.

A complete physical exam should be done. Tests may include:

  • Biopsy of the tumor
  • Chest x-ray
  • CT scan of the chest to look for spread of the tumor
  • CT scan of the tumor site
  • Bone marrow biopsy (may show the cancer has spread)
  • Bone scan to look for spread of the tumor
  • MRI scan of the tumor site
  • Spinal tap (lumbar puncture )

Treatment

Treatment depends on the site and type of rhabdomyosarcoma.

Either radiation or chemotherapy, or both, will be used before or after surgery. In general, surgery and radiation therapy are used to treat the primary site of the tumor. Chemotherapy is used to treat disease at all sites in the body.

Chemotherapy is an essential part of treatment to prevent further spread of the cancer. Many different chemotherapy drugs are active against rhabdomyosarcoma. Your doctor will discuss these with you.

Support Groups

The stress of illness can be eased by joining a cancer support group . Sharing with others who have common experiences and problems can help you not feel alone.

Outlook (Prognosis)

While aggressive treatment is usually necessary, most children with rhabdomyosarcoma achieve long-term survival. Cure depends on the specific type of tumor, its location, and how much it has spread.

Possible Complications

  • Complications from chemotherapy
  • Location in which surgery is not possible
  • Metastasis

When to Contact a Medical Professional

Call your health care provider if your child has symptoms of rhabdomyosarcoma.

References

Dome JS, Rodriguea-Galindo C, Spunt SL, Santana VM. Pediatric solid tumors. In: Niederhuber JE, Armitage JO, Doroshow JH, et al., eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2013:chap 95.

Goldblum JR, Folpe AL, Weiss SW. Rhabdomyosarcoma. In: Goldblum JR, Folpe AL, Weiss SW. Enzinger and Weiss's Soft Tissue Tumors. 6th ed. Philadelphia, Pa: Elsevier Saunders; chap 20.

National Cancer Institute: PDQ Childhood Rhabdomyosarcoma Treatment. Bethesda, Md: National Cancer Institute. Date last modified: November 26, 2013. Available at: http://cancer.gov/cancertopics/pdq/treatment/childrhabdomyosarcoma/HealthProfessional. Accessed: March 23, 2014.

Updated: 3/23/2014

Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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