Pediatric Rhabdomyosarcoma Clinical Presentation

Updated: Dec 08, 2022
  • Author: Timothy P Cripe, MD, PhD, FAAP; Chief Editor: Max J Coppes, MD, PhD, MBA  more...
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Rhabdomyosarcoma (RMS) usually manifests as an expanding mass; symptoms depend on the location of the tumor. Pain may be present. If metastatic disease is present, symptoms of bone pain, respiratory difficulty (secondary to lung nodules or to pleural effusion), anemia, thrombocytopenia, and neutropenia may be present. Disseminated rhabdomyoblasts in the bone marrow may mimic leukemia, both in symptoms and light microscopic findings.

Typical presentations by the location of nonmetastatic disease are as follows:

  • Orbit - Proptosis or dysconjugate gaze [2]

  • Paratesticular - Painless scrotal mass

  • Prostate - Bladder or bowel difficulties

  • Uterus, cervix, bladder - Menorrhagia or metrorrhagia

  • Vagina - Protruding polypoid mass (botryoid, meaning a grapelike cluster)

  • Extremity - Painless mass

  • Parameningeal (ear, mastoid, nasal cavity, paranasal sinuses, infratemporal fossa, pterygopalatine fossa) - Upper respiratory symptoms or pain [3]


Physical Examination

Physical findings depend on the location of the tumor. Tumors in superficial locations may be palpable and detected relatively early, but those in deep locations (eg, retroperitoneum) may grow large before causing symptoms.