Metastases to the breast from rhabdomyosarcoma: appearances on MRI

Abstract

The authors report a case of blood-borne bilateral metastatic breast disease of alveolar rhabdomyosarcoma (RMS) in a 21-year-old patient. The possibilities of mammography, ultrasound, and MRI in the early detection of breast metastases and their appearance on these modalities are discussed. Whereas mammography rendered no additional information due to dense breast parenchyma and ultrasound showed only a solitary tumor without definite criteria of malignancy, multifocal bilateral spread was verified with MRI and early ring-like enhancement suggested malignancy. Therefore, we conclude that MRI may provide useful information in evaluating patients with sarcomas, even when there is no clinical evidence for metastatic disease of the breast.

Rhabdomyosarcoma Metastasis to the Breast: Appearance on Diffusion-Weighted Imaging and Apparent Diffusion Coefficient Sequences

“…Previous reports of rhabdomyosarcoma metastases to the breast (1,2,3,13) demonstrated that a poor prognosis despite treatment, and relapse of this aggressive tumour, was observed in most patients (Table 1). Early diagnosis is recommended when suspicious lesions are detected in patients with primary rhabdomyosarcoma.…”

“…The primary tumor most commonly originates from the extremities. These tumors are also mostly of the alveolar subtype (2). Bilateral involvement is between 8% and 25% (1).…”

“…Bilateral involvement is between 8% and 25% (1). There are few articles that describe the imaging findings of rhabdomyosarcoma metastases to the breast on magnetic resonance imaging (MRI) (1)(2)(3). The variable morphological and enhancement patterns of benign and metastatic lesions to the breast on MRI suggest limited specificity of standard conventional contrastenhanced MRI in differentiating malignant from benign lesions (4)(5)(6).…”

An Unusual Imaging Finding of Breast Metastasis from Rhabdomyosarcoma

“…Most of the cases occur in adolescent females, and the most common primary site is the extremity. Breast metastasis from pleural RMS is extremely rare (5). The longest survival is known to be 16 months from the first diagnosis due to a poor prognosis (6).…”

Metastatic Breast Cancer From Rhabdomyosarcoma Mimicking Normal Breast Parenchyma on Sonography

“…5 Although sonography is useful in this setting, very few reports have described the sonographic appearance of rhabdomyosarcoma breast metastases. 2,6 In addition, metastasis to the breast can be an initial clinical manifestation of rhabdomyosarcoma in most cases. 4 For these reasons, the sonographic findings of rhabdomyosarcoma in the breast need to be emphasized.…”