Sposter presentation radio diagnosis msk

Case of randomyosarcoma

1. Title - A CASE OF RHABDOMYOSARCOMA OF LEFT THIGH Author - Dr. TUMMA SAHRUD REDDY Institute - Mamata Medical College, Khammam Phone no - 9010918260 Email Id - sahrud_reddy@yahoo .com

2. INTRODUCTION Rhabdomyosarcoma (RMS) is a malignant tumor with skeletal muscle cell morphology. It is one of the tumors of muscular origin. Rhabdomyosarcomas are the most common soft tissue tumor in children and account for 5-8% of childhood cancers 6-7, and 19% of all pediatric soft tissue sarcomas 7. In general, they are found in young patients, less than 45 years of age 6, with ~65% diagnosed in patients under 10 years old 7. There is a slight male predilection

3. METHOD A 39 year old man came with pain and swelling of left Thigh since 6 months No history of trauma. The swelling was painless in nature. On examination, a nontender swelling of approximate size 17cm × 12 cm was noticed on the left thigh, with no restriction of movements. Patient was subjected to X ray of left thigh AP view Gray scale USG with colour doppler MRI study— coronal T1W,T2W,PDFS,STI R, postcontrast T1W

4. RESULTS Plain radiograph anteroposterior view of the left thigh showed a large soft-tissue swelling of size 17cm × 12 cm over the anteromedial aspect of the left thigh, with no evidence of calcification and no erosions in the underlying bones. USG : well demarcated heterogenous predominantly hypoechoic soft tissue mass lesion of size 17cm × 12 cm noted over anteromedial aspect of left thigh. colour Doppler reveals increases vascularity within mass

5. MRI : MRI plain : shows evidence of well demarcated soft tissue mass mixed intensity lesion with few septations of approximate size 17cm × 12 cm along medial aspect of left thigh causing smooth indentation on adductor longus muscle .No evidence of any calcification or new bone formation or haemorrhage. Post Gd contrast Shows heterogeneous enhancement with few nodules Coronal T2W Coronal PDFS Coronal T1(post contrast) Coronal STIR

6. DISCUSSION RHABDOMYOSARCOMA is a soft tissue malignancy of skeletal origin, with < 20% occurrence in extremities They are categorized into two types: rhabdomyomatous and non rhabdomyomatous soft-tissue sarcomas. Rhabdomyosarcomas account for nearly 50% of pediatric soft-tissue sarcomas. These tumors are more common in children under the age group of 6 years, with slightly more male predilection. They are divided into three types: embryonal, alveolar, and pleomorphic. Embryonal and alveolar subtypes are more common in the pediatric population; pleomorphic type is commonly seen in adult population

7. CONCLUSION We report a case of 39 year old male who presented with history of soft tissue swelling and pain over anteromedial aspect of left thigh. Radiological and histopathological findings suggestive of RHABDOMYOSARCOMA. MR is investigation of choice for diagnosis as well as post treatment follow up of RHABDOMYOSARCOMA. Up to 20% of patients with rhabdomyosarcomas have metastases at the time of diagnosis 7. These are typical to lung and bone marrow. Treated with combination surgery, chemotherapy, and radiation: surgery: resection of a primary tumor, if necessary after downstaging chemoradiotherapy chemotherapy: common agents include vincristine, cyclophosphamide, dactinomycin, adriamycin, ifosfamide, VP-16 radiotherapy: external beam radiation is used in some cases of rhabdomyosarcoma

8. REFERENCES Agarwala S. Pediatric rhabdomyosarcomas and nonrhabdomyosarcoma soft tissue sarcoma. J Indian Assoc Pediatr Surg 2006;11:15. Saboo SS, Krajewski KM, Zukotynski K, Howard S, Jagannathan JP, Hornick JL, et al. Imaging features of primary and secondary adult rhabdomyosarcoma. AJR Am J Roentgenol 2012;199:W694-703. Back to cited text no. 13 Laffan EE, Ngan BY, Navarro OM. Pediatric soft-tissue tumors and pseudotumors: MR imaging features with pathologic correlation: Part 2. Tumors of fibroblastic/myofibroblastic, so-called fibrohistiocytic, muscular, lymphomatous, neurogenic, hair matrix, and uncertain origin. Radiographics 2009;29:e36. Park K, van Rijn R, McHugh K. The role of radiology in paediatric soft tissue sarcomas. Cancer Imaging 2008;8:102-15.