Rhabdomyosarcoma

What is rhabdomyosarcoma?

Although rhabdomysarcoma can begin anywhere in a child’s body, it usually develops in muscles connected to bones. There are three main types of rhabdomyosarcoma:

Embryonal. This is the most common type. It occurs most often in the head and neck area or the genital and urinary organs.
Alveolar. This type usually occurs during the teen years, developing most often in the arms or legs, chest, abdomen, genital organs or anal area.
Anaplastic. Although this type is rare, it is more common in adults than in children.

What are the symptoms of rhabdomyosarcoma in children?

Rhabdomyosarcoma usually appears as a swelling or a lump in a muscle and continues to grow. Symptoms of rhabdomyosarcoma depend on where the tumor is located and may include:

A growing lump or swelling that does not go away
Bulging around the eye socket
Headache
Urination or bowel problems
Hematuria (blood in the urine)
Bleeding in the nose, throat, vagina or rectum

Tumor growth can cause pain and can also affect the function of the body part where the tumor is located.

These inherited conditions can increase a person's risk of developing rhabdomyosarcoma:

Li-Fraumeni syndrome. Children with this rare, inherited condition that is characterized by a defective tumor suppressor gene are at high risk for developing multiple types of cancer, including rhabdomyosarcoma, leukemia and Wilms tumor.
Pleuropulmonary blastoma. This is a rare, very aggressive cancer of the lungs and tissue that covers the lungs and lines the interior wall of the chest cavity.
Neurofibromatosis-1 (NF1). Symptoms of neurofibromatosis-1 include brown spots and tumors on the skin and nerves.
Beckwith-Wiedemann syndrome. Babies with Beckwith-Wiedemann syndrome are large at birth and may develop low blood sugar.
Costello syndrome. Symptoms of Costello syndrome include intellectual disability, loose folds of skin and unusually flexible joints.
Noonan syndrome. Symptoms of Noonan syndrome include heart defects, bleeding problems and skeletal malformations.

Your child’s doctor can help you evaluate risk factors for rhabdomyosarcoma. The cause of rhabdomyosarcoma is not usually known.

Diagnosis of rhabdomyosarcoma

If your child shows symptoms of rhabdomyosarcoma, a pediatric oncologist at Riley at IU Health can perform the following exams and tests to make a diagnosis:

Physical exam and medical history. The oncologist (cancer doctor) will review your family's medical history and conduct a thorough physical exam of your child.
Computed tomography (CT). This fast, painless imaging procedure uses X-rays to create multiple cross-sectional images of bone and tissue to reveal tumors, their size and whether they have spread to other areas.
Magnetic resonance imaging (MRI). This imaging procedure uses a magnetic field and radio waves to show tumors in bone, muscle and soft tissue in great detail.
X-ray. This technology can show tumors in bone but not much detail in internal organs. CT scans often take the place of X-ray imaging

Treatment for rhabdomyosarcoma in children

Treatment options and prospects for recovery depend on:

Where the tumor is first developed in the body
The tumor’s width at diagnosis
If the tumor has spread to nearby lymph nodes or throughout the body
Any changes in the genes
If surgery completely removes the tumor
How the tumor responds to chemotherapy and/or radiation therapy
If the tumor is recently diagnosed or recurring

Rhabdomyosarcoma may be treated with one or a combination of the following:

Surgery. Depending on the tumor's location, surgery may be performed to remove the tumor and/or part or all of the affected organ or bone.
Chemotherapy. Chemotherapy involves taking medicines that destroy cancer cells. These medicines can be taken orally or intravenously.
Radiation therapy. High-energy radiation is directed on the tumor to shrink or destroy it or to kill cancer cells that have spread outside the bone.

Key Points to Remember

Rhabdomyosarcoma is the most common type of soft tissue cancer in children.
Sarcomas are cancerous tumors that can develop in bone, soft tissue (such as muscle) or connective tissue (tendons or cartilage).
Certain inherited conditions increase the risk of rhabdomyosarcoma.
Symptoms of rhabdomyosarcoma include a growing lump or swelling that does not go away, bulging around the eye socket and headaches.
Treatment for this condition includes surgery, chemotherapy and radiation therapy.

Support Services & Resources

Learn more about rhabdomyosarcoma by visiting the following recommended online resources.

Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.

Learn More About Riley Support Services

National Cancer Institute

The National Cancer Institute provides general information about childhood rhabdomyosarcoma on its website.

American Cancer Society

Find in-depth information about rhabdomyosarcoma, including support information, in this online guide.