Title:Multimodality Imaging Evaluation of Nasal Rhabdomyosarcoma in Adults: A Case Report and Literature Review
Volume: 18
Issue: 1
Author(s): Lujiao Chen*, Bo Chen, Shanlu Yu, Zhenhua Zhao and Liyijing Shen*
Affiliation:
- Department of Radiology, Shaoxing People’s Hospital, Shaoxing, Zhejiang Province, China
- Department of Radiology, Shaoxing People’s Hospital, Shaoxing, Zhejiang Province, China
Keywords:
Alveolar rhabdomyosarcoma, 18F-FDG, PET/CT, X-ray computed tomography, magnetic resonance imaging, case report.
Abstract:
Background: Alveolar rhabdomyosarcoma (ARMS) predominantly affects adolescents
aged 10-15 years and is distinguished by its high aggressiveness and adverse prognosis
compared with other sarcomas. It exhibits a pronounced tendency for lymphatic and hematogenous
metastases at early stages. ARMS commonly manifests in the limbs and genitourinary
system, with occurrences in the head and neck region being relatively uncommon. The role of
CT, MRI, and 18F-FDG positron emission tomography combined with computed tomography
(PET/CT) in the diagnostic process of ARMS is yet to be fully established.
Case Report: We report the case of a 49-year-old woman who presented with hematological
nasal discharge for one month. CT imaging revealed a soft tissue mass in the left nasal cavity.
MRI demonstrated a marginally hypo- to isointense signal on T1-weighted images, a hyperintense
signal on T2-weighted images, and heterogeneous enhancement post-contrast. 18F-FDG
PET/CT identified a hypermetabolic lesion located within the left nasal cavity. Surgical intervention
entailed the excision of the left intranasal mass and the skull base lesion. Postoperative
pathological analysis indicated ARMS.
Conclusion: Sinus ARMS is notably malignant and associated with a dismal prognosis. Accurate
diagnosis depends on histopathological and immunohistochemical evaluation, complemented
by genetic analysis for specific chromosomal translocations and fusion genes. Imaging techniques,
including CT, MRI, and PET/CT, are crucial for assessing lesion extent and metastasis,
supporting disease diagnosis, informing treatment choices, facilitating surgical planning, and
monitoring response to therapy.
