Pediatric Head and Neck Rhabdomyosarcoma

  • Etiology: malignant neoplasm of striated muscle
  • Imaging: most often medial-superior quadrant, commonly intracranial extension + osseous destruction
  • 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 Head and Neck Rhabdomyosarcoma

MRI of rhabdomyosarcoma
Axial T1 MRI without (above left) and with contrast (above right) of the orbits show a solid homogenously enhancing mass arising superior and medially to the right orbit which shows restricted diffusion on diffusion weighted imaging (below right).