Rhabdomyosarcomas can develop anywhere, but the head and neck, genital or urinary tract, and limbs are the most common locations.
Symptoms depend on where rhabdomyosarcomas develop.
Diagnosis involves imaging tests and a biopsy.
Treatment consists of chemotherapy, surgery, and sometimes radiation therapy.
(See also Overview of Childhood Cancer Overview of Childhood Cancer In the United States, the overall incidence of cancer in children and adolescents has increased over time. From 1975 to 2022, rates increased by approximately 0.8 per 100,000 each year. However... read more .)
About 400 to 500 cases of rhabdomyosarcoma occur in children in the United States each year. This cancer accounts for 3% of all cancers in children. Two thirds of cases of this cancer are diagnosed in children younger than 7 years of age. Rhabdomyosarcomas occur mostly in children.
This cancer develops from cells that would normally develop into muscle cells. The cause of rhabdomyosarcoma is unknown.
Although rhabdomyosarcoma can occur almost anywhere, it tends to occur most often in the following:
Head and neck (in about 35% of cases): Most common among school-aged children
Genital or urinary tract (in about 25% of cases), usually in the bladder, prostate, or vagina: Typically occurring in infants and toddlers
Limbs (in about 20% of cases): Most common among adolescents
Trunk or other miscellaneous sites (in about 20% of cases)
Rhabdomyosarcoma can spread (metastasize) to other parts of the body. But it is usually diagnosed before the cancer has spread. About 15 to 25% of children are diagnosed after the cancer has spread. In these children, the cancer is most commonly located in the lungs. Bones, bone marrow, and the lymph nodes are other locations to which the cancer may spread.
Symptoms of Rhabdomyosarcoma
In most children, the first symptom of the cancer is a firm lump or problems related to an organ affected by the cancer, such as the following:
Eyes: Tearing, eye pain, or a bulging eye
Nose and throat: Nasal congestion, a change in the voice, or a nasal discharge that contains mucus and pus
Genital or urinary tract: Abdominal pain, a lump in the abdomen that can be felt, difficulty urinating, and blood in the urine
Vagina: Discharge that contains mucus and blood or a polyp-like mass that sticks out of the vagina
Limbs: Firm lumps on the arms or legs
Limb cancers frequently spread, especially to the lungs, bone marrow, and lymph nodes. Usually, this spread does not cause symptoms.
Diagnosis of Rhabdomyosarcoma
Computed tomography (CT) or magnetic resonance imaging (MRI)
Biopsy or removal of tumor
If a lump is detected, CT Computed Tomography (CT) In computed tomography (CT), which used to be called computed axial tomography (CAT), an x-ray source and x-ray detector rotate around a person. In modern scanners, the x-ray detector usually... read more 
or MRI Magnetic Resonance Imaging (MRI) In magnetic resonance imaging (MRI), a strong magnetic field and very high frequency radio waves are used to produce highly detailed images. MRI does not use x-rays and is usually very safe... read more 
is done.
The diagnosis of rhabdomyosarcoma is confirmed by taking a sample from the lump and examining it under a microscope (biopsy). Sometimes the entire lump is removed surgically.
To determine whether the cancer has spread, CT of the chest, a bone scan (radionuclide scanning Radionuclide Scanning In radionuclide scanning, radionuclides are used to produce images. A radionuclide is a radioactive form of an element, which means it is an unstable atom that becomes more stable by releasing... read more of bones), and another type of radionuclide scanning called positron emission tomography–CT (PET-CT PET computed tomography (PET-CT) Positron emission tomography (PET) is a type of radionuclide scanning. A radionuclide is a radioactive form of an element, which means it is an unstable atom that becomes more stable by releasing... read more 
) are done, and a sample of bone marrow is removed Bone Marrow Examination Red blood cells, most white blood cells, and platelets are produced in the bone marrow, the soft fatty tissue inside bone cavities. Sometimes a sample of bone marrow must be examined to determine... read more from both hip bones and examined.
Treatment of Rhabdomyosarcoma
Chemotherapy and surgery
Sometimes radiation therapy
(See also Cancer Treatment Principles Cancer Treatment Principles Treating cancer is one of the most complex aspects of medical care. It involves a team that encompasses many types of doctors working together (for example, primary care doctors, gynecologists... read more .)
Treatment consists of chemotherapy Chemotherapy and Other Systemic Cancer Treatments Systemic treatments are those that have effects throughout the body rather than being applied directly to the cancer. Chemotherapy is a form of systemic treatment that uses drugs to kill cancer... read more and surgery Surgery for Cancer Surgery is a traditional form of cancer treatment. It is the most effective in eliminating most types of cancer before it has spread to lymph nodes or distant sites (metastasized). Surgery may... read more , radiation therapy Radiation Therapy for Cancer Radiation is a form of intense energy generated by a radioactive substance, such as cobalt, or by specialized equipment, such as an atomic particle (linear) accelerator. Radiation preferentially... read more , or a combination of all three treatments.
All children are treated with chemotherapy. The most common chemotherapy drugs used are vincristine, dactinomycin, cyclophosphamide, doxorubicin, ifosfamide, and etoposide. Topotecan and irinotecan are other drugs that may also be used.
When surgery is done, the entire cancer is removed if possible.
Radiation therapy is typically used if some cancer remains after surgery or if the cancer is considered intermediate risk or high risk.
Prognosis for Rhabdomyosarcoma
The prognosis is based on several factors:
Where the cancer is located
How much of the cancer can be removed
Whether it has spread
How old the child is
What the cancer cells and tissue look like when examined under a microscope
The prognosis is worse for children who are under 1 year of age or who are over 10 years of age.
Children are considered low risk, intermediate risk, or high risk depending on their combination of factors. More than 90% of children who are considered low risk survive, but less than 50% of children who are considered high risk survive.
More Information
The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.
American Cancer Society: If Your Child Is Diagnosed With Cancer: A resource for parents and loved ones of a child who has cancer that provides information about how to cope with some of the problems and questions that come up just after a child is diagnosed
Drugs Mentioned In This Article
| Generic Name | Select Brand Names |
|---|---|
vincristine |
Oncovin, Vincasar PFS |
dactinomycin |
Cosmegen |
cyclophosphamide |
Cyclophosphamide, Cytoxan, Neosar |
doxorubicin |
Adriamycin, Adriamycin PFS, Adriamycin RDF, Rubex |
ifosfamide |
Ifex |
etoposide |
Etopophos, Toposar, VePesid |
topotecan |
Hycamtin |
irinotecan |
Camptosar |
