Pediatric Genitourinary Rhabdomyosarcoma

  • Etiology: malignant neoplasm of striated muscle
  • Imaging: arise from bladder or prostate or vagina
  • MRI: intermediate to hypointense on T1WI, intermediate to hyperintense on T2WI, enhances heterogeneously, improved conspicuity on DWI
  • Complications: metastasis to lung
  • Clinical: most common childhood soft tissue sarcoma, 50% head and neck / 30% genitourinary / 20% musculoskeletal, embryonal cell type seen in infants is most common, alveolar cell type seen in older children and affects musculoskeletal system and is more aggressive, orbital has best prognosis

Radiology Cases of Genitourinary Rhabdomyosarcoma

Radiology Cases of Bladder Rhabdomyosarcoma

IVP and CT of rhabdomyosarcoma of the bladder
AP image from the excretory phase of a vintage intravenous pyelogram (above) shows bilaterally normal appearing renal collecting systems and ureters. There is a multilobulated circumferential filling defect in the base of the badder. Axial CT with contrast of the abdomen shows the mass to almost complete fill the base of the bladder.

Radiology Cases of Prostatic Rhabdomyosarcoma

CT of prostatic rhabdomyosarcoma
Axial CT with contrast of the abdomen shows a soft tissue mass arising from between the bladder and rectum that is invading into the posterior wall of the bladder, resulting in filling defects within the bladder.

Surgery Cases of Genitourinary Rhabdomyosarcoma

Surgery Cases of Bladder Rhabdomyosarcoma

Surgical image of rhabdomyosarcoma of the bladder
Surgical image shows the mass (between the surgeon’s fingers) to be extraperitoneal in location, originating from the left posterior aspect of the dome of the bladder. The mass did not appear to invade any normal structures except where it originated in the bladder, which is along the inferior edge of the image.