Rhabdomyosarcoma of biliary tract- a diagnostic dilemma
V Kumar1, S Chaudhary, M Kumar
1Department of Pediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005 U.P. India.
Insights
Rhabdomyosarcoma, a rare pediatric soft tissue tumor, can cause malignant obstructive jaundice. This case highlights the importance of considering rhabdomyosarcoma in children with jaundice, even when imaging suggests other conditions.
Area of Science:
- Pediatric Oncology
- Surgical Pathology
- Hepatobiliary Surgery
Background:
- Rhabdomyosarcoma is a rare malignant soft tissue tumor in children.
- It is a leading cause of malignant obstructive jaundice in pediatric patients.
- Accurate diagnosis is crucial for effective treatment and improved outcomes.
Observation:
- A 4-year-old child presented with obstructive jaundice and hepatomegaly.
- Initial imaging studies misdiagnosed the condition as a choledochal cyst.
- Intraoperative findings and histopathology confirmed rhabdomyosarcoma.
Findings:
- Surgical management involved mass excision and Roux en Y portoenterostomy.
- The patient received postoperative multimodal chemotherapy.
- Histopathological confirmation is essential for differentiating rhabdomyosarcoma from other causes of jaundice.
Implications:
- This case underscores the diagnostic challenges of pediatric rhabdomyosarcoma presenting as obstructive jaundice.
- Early and accurate diagnosis is critical for timely intervention and treatment.
- Reporting uncommon presentations aids in medical literature and clinician awareness.
Abstract:
Rhabdomyosarcoma is a soft tissue malignant musculoskeletal tumor. It is a rare tumor in children but the most common cause of malignant obstructive jaundice in them. A 4-year-old child presented to us with obstructive jaundice and palpable liver. He was misdiagnosed as choledochal cyst on imaging studies; however, intraoperative and histopathological features confirmed the diagnosis of rhabdomyosarcoma. Mass excision and Roux en Y portoenterostomy was performed. Post operatively; the patient was put on multimodal chemotherapy. This, being an uncommon entity, is being reported with a review of the available literature.
