• Rhabdomyosarcoma Overview

    The most common soft-tissue sarcoma in children, Rhabdomyosarcoma is a cancerous tumor that grows in the soft tissue of the body. The most common sites for this tumor are the head, neck, bladder, vagina, arms, legs and trunk. They can also be found in places where skeletal muscles are absent or very small, such as the prostate, middle ear, or the bile duct system.

    Rhabdomyosarcoma Treatment at Dana-Farber/Boston Children's

    Patients with rhabdomyosarcoma are treated at Dana-Farber/Boston Children's Cancer and Blood Disorders Center through the Bone & Soft Tissue Program. Continue reading to learn more about rhabdomyosarcoma or visit the Bone & Soft Tissue Program homepage to learn about our expertise.

    Symptoms & Diagnosis

    Symptoms of rhabdomyosarcoma may not be present until the tumor is very large, especially if it is located deep in muscles or in the stomach. Common symptoms include:

    • A mass that can be seen or felt and may or may not be painful
    • Bleeding from the nose, vagina, rectum or throat (if the tumor is located in these areas)
    • Tingling, numbness, pain if the tumor compresses a nerve in the affected area
    • Protrusion of the eye or drooping eyelid, which may indicate a tumor behind the eye 

    A physician may order a number of different tests to diagnose rhabdomyosarcoma. In addition to a medical history and physical exam, these may include:

    • Blood and urine tests
    • Computerized tomography (CT or CAT) scan
    • Magnetic resonance imaging (MRI)
    • X-ray
    • Ultrasound
    • Bone scans
    • Bone marrow biopsy and/or aspiration
    • Biopsy 
    • Lumbar puncture (spinal tap)

    After all tests are completed, doctors will be able to outline the best treatment options.

    Treatment & Care Options

    Surgery is almost always performed to diagnose rhabdomyosarcoma and to provide information about the stage of the tumor. Complete surgical removal of these tumors is often not possible.  

    Tumors in areas that cannot be resected upfront, such as the head and neck, the bladder, the vagina, or prostate require chemotherapy or radiation therapy prior to attempts at surgical removal.  Tumors in the muscles of the arms or legs are treated initially with surgical removal when possible, followed by chemotherapy, with or without radiation therapy. Tumors around the eye are responsive to chemotherapy and radiation, so they rarely require surgical removal. 

    There can be side effects related to the tumor itself or its treatment. Knowing what these side effects are can help a physician prepare for and, in some cases, prevent these symptoms from occurring.

    Progressive or Recurrent Disease

    Relapses are uncommon after five years of disease-free survival. Relapse is common, however, in patients who have residual disease in an unfavorable site following initial surgery and those whose disease has already spread at the time of diagnosis.

    Long-term Outlook

    The long-term outlook for children with rhabdomyosarcoma varies greatly, depending on the extent of disease, size and location of the tumor, and if the tumor has spread to other parts of the body. These tumors are usually curable in children with localized disease who have received combination therapy, with more than 70 percent surviving five years after diagnosis.
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