Paratesticular Embryonal Rhabdomyosarcoma Masquerading as Epididymitis: A Diagnostic Challenge in Adolescents

Area of Science:

• Pediatric Oncology
• Skeletal Muscle Tumors
• Diagnostic Imaging

Background:

• Paratesticular rhabdomyosarcoma is a rare pediatric malignancy.
• It often presents with symptoms mimicking benign conditions like epididymo-orchitis.
• Diagnostic delays can negatively affect patient outcomes.

Purpose of the Study:

• To report a case of paratesticular rhabdomyosarcoma in a pediatric patient.
• To emphasize the importance of considering malignancy in non-responsive scrotal masses.
• To highlight the role of advanced imaging in diagnosis.

Main Methods:

• Case report of a 14-year-old male with scrotal swelling.
• Initial misdiagnosis as epididymo-orchitis, treated with antibiotics.
• Diagnostic workup included serial ultrasounds, MRI, and CT staging.
• Confirmation via radical inguinal orchiectomy and histopathology/immunohistochemistry.

Main Results:

• The patient presented with symptoms initially suggestive of infection.
• Despite antibiotic treatment, the condition worsened, revealing a paratesticular mass.
• Imaging confirmed a large, heterogeneous mass with lymphadenopathy.
• Histopathology confirmed embryonal rhabdomyosarcoma with specific markers.

Conclusions:

• Persistent scrotal masses unresponsive to antibiotics warrant high suspicion for malignancy.
• Prompt and accurate diagnosis through advanced imaging is critical.
• Multimodal treatment is essential for managing pediatric paratesticular rhabdomyosarcoma.