Pediatric Rhabdomyosarcoma Surgery Clinical Presentation

Updated: Dec 05, 2016
  • Author: Roshni Dasgupta, MD, MPH; Chief Editor: Eugene S Kim, MD, FACS, FAAP  more...
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Presentation

History

The clinical presentation of rhabdomyosarcoma (RMS) varies according to the site of presentation. Most patients, however, present with a painless mass, often discovered after minor trauma. Growth of the mass may impact adjacent structures, thus causing symptoms, including pain. When large, RMS may impinge on adjacent structures and lead to secondary problems such as bowel obstruction or respiratory distress.

Other symptoms are determined by location of the mass. Tumors originating in the head and neck may present as a mass or as signs and symptoms of central nervous system involvement due to intracranial extension of the tumor or infiltration of the cranial nerves, meninges, or brainstem. [20, 21]  RMS of the orbit may result in disconjugate gaze, whereas RMS of the uterus, cervix, or bladder may result in menorrhagia or metrorrhagia or difficulty voiding. 

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Physical Examination

In many instances, physical examination may be positive only for lymphadenoapathy in the region of the tumor. Other findings are dependent on tumor location. Secondary signs may include anemia, thrombocytopenia and neutropenia. Many patients have no physical examination findings at the time of diagnosis.

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