Rhabdomyosarcoma

Rhabdomyosarcoma is a type of soft tissue sarcoma. It begins in cells that normally develop into skeletal muscle, the muscles that let you move and control parts of your body. It is the most common soft tissue sarcoma in children, and it is also seen in teens.

Because skeletal muscle cells are found throughout the body, rhabdomyosarcoma can start in many different places. Like other sarcomas, it can grow into nearby tissue and, in some cases, spread to other parts of the body.

Types & Stages

Rhabdomyosarcoma has a few main types. Knowing the type helps the care team understand how the tumor may behave and plan treatment.

• Embryonal rhabdomyosarcoma. This is the most common type in children. It often starts in the head and neck area, the bladder, or the reproductive organs.
   
• Alveolar rhabdomyosarcoma. This type can grow more quickly and is often found in the arms, legs, or trunk. It tends to need more intensive treatment.
   
• Pleomorphic or spindle cell/sclerosing rhabdomyosarcoma. These are less common forms. Pleomorphic rhabdomyosarcoma is seen more often in adults.

Rhabdomyosarcoma is often described in simple terms based on how far it has spread:

• Localized. The cancer is found only where it started and has not spread to other parts of the body.
   
• Regional spread. The cancer has grown into nearby tissues or lymph nodes.
   
• Distant spread (metastatic). The cancer has spread to distant parts of the body, such as the lungs, bones, or bone marrow.

Your child's care team will use the type, location, tumor size, and whether it has spread to plan treatment.

Signs & Symptoms

The symptoms of rhabdomyosarcoma depend a lot on where the tumor starts. The first sign is often a lump or swelling, but other symptoms can appear based on the tumor's location.

Visit a doctor if your child has any of these symptoms:

• A lump or swelling that may keep growing
• Pain in the area of the tumor
• Trouble urinating or having bowel movements
• Bulging or swelling of an eye
• Nose or ear symptoms, such as stuffiness, drainage, or bleeding
• Bleeding from the nose, throat, vagina, or rectum, depending on location

Many of these symptoms can be caused by conditions that are not cancer. Still, it is important to have any new, lasting, or unusual symptom checked by a healthcare provider.

Diagnosis

Tests and procedures used to diagnose rhabdomyosarcoma may include:

• Physical exam and history. The doctor checks your child's overall health and asks about symptoms, how long they have lasted, and family health history.
   
• Imaging tests. An MRI or CT scan can show the size, depth, and location of the tumor and whether it has spread. A PET scan may be used when needed to look for cancer in other parts of the body.
   
• Biopsy. A biopsy removes a small sample of the tumor so it can be examined under a microscope by a pathologist. This is the only way to confirm rhabdomyosarcoma and identify its type.
   
• Staging tests. Other tests, such as a bone marrow exam or additional imaging, may be done when appropriate to learn whether the cancer has spread.

Treatment

Treatment for rhabdomyosarcoma depends on the tumor's type, location, and size, whether it has spread, and your child's overall health. Care is usually guided by pediatric sarcoma specialists at centers experienced in treating childhood cancers.

Treatment often uses a combination of therapies, which may include:

• Surgery. The surgeon removes the tumor when it can be taken out safely, often with a margin of healthy tissue. Sometimes surgery is done after other treatments shrink the tumor.
   
• Chemotherapy. Chemotherapy uses medicines to kill cancer cells or slow their growth. It is a key part of treatment for rhabdomyosarcoma and helps treat cancer throughout the body.
   
• Radiation therapy. Radiation uses high-energy beams to kill cancer cells. It may be used to treat the tumor and help lower the chance that the cancer comes back.

These treatments are often combined and timed to work together. Clinical trials may also be an option. These studies test new treatments or new ways to use current ones. Ask your care team whether a clinical trial may be right for your child.

Causes & Risk Factors

The exact cause of rhabdomyosarcoma is usually not known. It begins when cells that normally develop into skeletal muscle have changes in their DNA that cause them to grow out of control.

In most cases, these changes are not inherited. However, some inherited conditions can raise the risk of developing rhabdomyosarcoma. Families with a known genetic syndrome or a strong family history of cancer may benefit from talking with a healthcare provider or genetic counselor.

Having a risk factor does not mean a child will develop rhabdomyosarcoma, and most children with the disease have no known risk factors. Talk with your healthcare provider about your child's personal risk.

Screening

There is no routine screening test for rhabdomyosarcoma for children at average risk.

Because this cancer is rare, it is most often found when a child has symptoms, such as a lump or swelling, or during tests done for another reason. There is no recommended test to look for rhabdomyosarcoma in children who feel well and have no symptoms.

Children with a known inherited condition that raises their risk may need closer follow-up. A healthcare provider or genetic counselor can help guide this care.

If your child has symptoms that are new, lasting, or unusual, do not wait. Talk with a healthcare provider about the symptoms and whether further evaluation is needed.

This information is for general education only and is not a substitute for medical advice. Please consult a qualified healthcare provider for diagnosis, treatment recommendations, and guidance based on your child's personal health history.