A Pediatric Radiology Textbook and Pediatric Radiology Digital Library
Pediatric Paratesticular Rhabdomyosarcoma
Etiology: Malignant neoplasm of striated muscle
Imaging: Hypervascular mass encasing or invading testicle and which may extend beyond tunica albuginea
DDX: May present as painless swelling in scrotum or inguinal canal and must be differentiated from inguinal hernia or hydrocele or varicocele
Complications: High predilection of lymph node spread to retroperitoneum especially in boys over 10 years old so retroperitoneal lymph node dissection is required
Treatment:
Clinical: — Most common solid extratesticular mass — Bimodal distribution – first 3 years of life or adolescence — Nearly 80% diagnosed by age 14 — Significantly better outcome than lesions elsewhere in genitourinary tract
Radiology Cases of Paratesticular Rhabdomyosarcoma
Sagittal color doppler US of the left scrotum (left) shows the left testicle to be unremarkable. Sagittal (above right) and transverse (below right) color doppler US of the right scrotum shows it to be filled with a large fairly homogeneous and hypervascular mass. A discrete right testicle could not be identified on ultrasound. In the operating room, a normal right testicle was seen medial to and adherent to and almost completely encased by this large mass.
