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Grid Malalignment Artifact
Joseph Junewick, MD FACR
over 5 years ago
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ARSt Case Repository

Porta Hepatis Rhabdomyosarcoma

Case Detail

Anatomy: Gastrointestinal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 5 years ago
Updated: over 5 years ago
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Modality/Study Types: US CT NM
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History

2 year old male with jaundice.


Case Images


Diagnosis

Bilary Rhabdomyosarcoma

Findings

PET/CT – Infiltrative hypodense mass in the porta hepatis extending along the biliary ducts on CT and showing corresponding hypermetabolism on FDG imaging.

US – Hypoechoic mass in porta hepatis with dilated bile ducts.

Discussion

Biliary rhabdomyosarcoma occurs almost exclusively in children, diagnosed before the age of 5 years in most cases. Jaundice is the most common symptom although abdominal distention, fever, hepatomegaly, or nausea/vomiting may also be present. Laboratory examination usually reveals elevated bilirubin and alkaline phosphatase and normal serum AFP. Metastatic disease is present at diagnosis in up to a third of cases. Only the embryonal subtype of rhabdomyosarcoma occurs in the biliary tree. Rhabdomyoblasts infiltrate the subepithelial stroma of the biliary ducts. Immunohistochemical studies reveal positive reactions for muscle markers.

Reference

Chung EM, Lattin GE, Cube R, et al. Pediatric Liver Masses: Radiologic-Pathologic Correlation Part 2. Malignant Tumors. RadioGraphics 2011; 31:483–507.



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