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Rhabdomyosarcoma

 

Routes of Spread

 

The routes of spread are:

  • Local 
    • Infiltration and spread along tissue planes - sometimes for great distances.
  • Regional lymphatics 
    • Overall 5% incidence of metastatic disease to lymph nodes in all sites except:
      • Paratesticular: 40%
      • Genitourinary: about 20%
      • Extremity: 15 - 20%
      • Orbit: almost 0%.
  • Hematogenous
    • To distant sites such as lung, bone and bone marrow (occurs in about 10-20% of patients at presentation). 
    • The primaries are usually in the extremities, trunk or retroperitoneum. 
    • Bone metastases are often seen in the small bones of the hands and feet.
  • Leptomeningeal
    • Parameningeal tumors can be associated with meningeal thickening and spread via CSF pathways.

 

CSF Cytology: Below are small round blue tumor cells found in the CSF of a patient with leptomeningeal disease from rhabdomyosarcoma.

 

 

 

 

 

 

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