Musculoskeletal Imaging

Rhabdomyosarcoma

a highly malignant soft tissue tumour arising in muscle. Very rarely, however, a rhabdomyosarcoma can develop as a primary neoplasm of bone.

Both children and adults may be affected. Three histologic types are recognized:

  • the embryonal type, which is the most common type and typically occurs in children;

  • the alveolar type, which tends to affect older children and young adults and is frequently found in the extremities; and

  • the pleomorphic type, which is the least common and predominates in the skeletal muscles of adults.

    In children, most often the tumours occur in the head and neck or genitourinary tract; in adults the deep soft tissues of the extremities are the predominant site. Infiltration of local tissues and distant spread to the lungs and occasionally to the lymph nodes are common.

    On radiographs the tumours appear as poorly defined soft tissue masses, which tend to involve adjacent bone (Fig.1) (Fig.2). A motheaten bone destruction or permeative bone destruction is common. Calcification within the tumour may also occur.

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    Fig.2

    Oblique (a) and AP (b) radiographs of the mandible demonstrate an expansile osteolytic lesion of the body and angle of the mandible. (Courtesy of Thomas Broderick, MD, Orange, CA)
    Rhabdomyosarcoma, Fig.1
    Rhabdomyosarcoma, Fig.2 (a)
    Rhabdomyosarcoma, Fig.2 (b)