Computed tomography and magnetic resonance imaging observations of rhabdomyosarcoma in the head and neck

Abstract

Head and neck (HN) rhabdomyosarcoma (RMS) is an aggressive malignancy, which is rarely encountered and is commonly misdiagnosed as another type of tumor. The aim of the present study was to investigate the computed tomography (CT) and magnetic resonance imaging (MRI) features of HNRMS and analyze the correlations between the imaging observations and the pathological subtypes. A total of 10 HNRMS patients (three males and seven females; median age, 16 years) were reviewed retrospectively by only CT (n=1), only MRI (n=2), as well as CT and MRI (n=7). In addition, the clinical data, imaging observations and pathological results were recorded and analyzed. The origins of the 10 HNRMSs (eight embryonal and two alveolar subtypes) included the ethmoid sinus (n=4), maxillary sinus (n=1), orbit (n=3), nasopharynx (n=1) and frontotemporal subcutaneous area (n=1). On the CT and MRI images, the soft-tissue masses exhibited ill-defined borders (n=9), bony destruction (n=10), multi-cavity growth (n=7) and cervical lymph node metastasis (n=2), whereas calcification and hemorrhaging were not identified. On CT, eight of the HNRMSs appeared slightly hypodense (2/8) or isodense (6/8) with homogeneous enhancement (4/4). On T1-weighted images (WI), nine tumors exhibited isointensity (9/9) and on T2WI, six tumors demonstrated homogeneous hyperintensity with homogeneous enhancement on contrast-enhanced (CE)-T1WI. In addition, three embryonal RMSs, which originated from the ethmoid sinus, exhibited heterogeneous hyperintensity on T2WI and nodule-shaped enhancement patterns on CE-T1WI. The results of the present study indicated that MRI may accurately demonstrate the location and extent of HNRMS and that the imaging features of HNRMS may be similar to those of other tumors. However, a tumor exhibiting heterogeneous hyperintensity on T2WI and a nodule-shaped enhancement pattern on CE-T1WI in the ethmoid sinus may present specific MRI features, which clearly indicates the botryoid subtype of embryonal RMS.

Multiparametric MRI findings of sinonasal rhabdomyosarcoma in adults with comparison to carcinoma

“…Diverse conventional CT and MRI findings have been reported in patients with adult rhabdomyosarcoma in the head and neck region, including the sinonasal region . CT findings of adult rhabdomyosarcoma in the head and neck region have been described as showing poorly defined, inhomogeneous soft‐tissue masses destroying adjacent bone with uncommon necrosis, hemorrhage, and calcification . However, these imaging findings were nonspecific and can be confused with other types of malignant sinonasal tumors.…”

“…Computed tomography (CT) and magnetic resonance imaging (MRI) has been reported to play important roles in the diagnosis of many kinds of tumors in the head and neck region, including the sinonasal region . There have also been a few reports focused on head and neck rhabdomyosarcoma in adults . However, the previous studies indicated that, although MRI may accurately demonstrate the location and extent of rhabdomyosarcoma, the imaging features of rhabdomyosarcoma may be similar to those of other malignant tumors of the head and neck .…”

“…There have also been a few reports focused on head and neck rhabdomyosarcoma in adults . However, the previous studies indicated that, although MRI may accurately demonstrate the location and extent of rhabdomyosarcoma, the imaging features of rhabdomyosarcoma may be similar to those of other malignant tumors of the head and neck . Moreover, reports of MRI features of adult rhabdomyosarcoma in the sinonasal region are few and limited to case reports .…”

Progressive Left Periorbital Swelling

“…8 On CT, Ewing sarcoma appears as a diffuse, unevenly enhancing mass associated with mottled bone destruction, making the exact site of origin difficult to determine. 5 Lymphoma of the orbit is hyperdense on CT, hypointense on T1-weighted MRI, and hypointense to hyperintense on T2-weighted MRI with homogeneous enhancement. Typically, lymphoma molds to rather than destroys the orbital rim.…”

“…Furthermore, different subtypes may have different radiographic findings. 5 They are commonly isodense or slightly hypodense on precontrast CT images with homogeneous enhancement on postcontrast CT images. They are isointense or variably hyperintense on T1-weighted MRI.…”