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Rhabdomyosarcoma Diagnosis

Rhabdomyosarcomas can often be detected with a chest X-ray, MRI or CT scan. However, since the tumors can be similar to other cancers, a biopsy is needed to confirm the diagnosis. After the diagnosis, a bone marrow aspiration will be performed to determine if the cancer has spread to the bone marrow. A sample of marrow is extracted from the pelvic bones with a needle and examined under the microscope.

Second Opinions at MD Anderson

The pathologists at MD Anderson are highly specialized in diagnosing and staging rhabdomyosarcomas, and we welcome the opportunity to provide second opinions.

If you would like to get a second opinion at MD Anderson, call 1-877-632-6789 to make an appointment or request an appointment online.

Rhabdomyosarcoma Staging

(source: National Cancer Institute)

Staging of rhabdomyosarcoma is done in three related steps: 

  • A staging system
  • A grouping system
  • A risk group

Staging

The staging system is based on the size of the tumor, where it is in the body, and whether it has spread to other parts of the body. Rhabdomyosarcoma that occurs in a "favorable" site has a better prognosis. If the site where cancer occurs is not one of the favorable sites listed below, it is said to be an "unfavorable" site.

Stage 1: Cancer is any size, has not spread to lymph nodes, and is found in only one of the following "favorable" sites:

  • Eye or area around the eye.
  • Head and neck (but not in the tissue next to the brain and spinal cord).
  • Gallbladder and bile ducts.
  • In the testes or vagina (but not in the kidney, bladder, or prostate).

Stage 2: Cancer is found in any one area not included in stage 1. The tumor is 5 centimeters or smaller and has not spread to lymph nodes.

Stage 3: Cancer is found in any one area not included in stage 1 and one of the following is true:

  • The tumor is 5 centimeters or smaller and cancer has spread to nearby lymph nodes.
  • The tumor is larger than 5 centimeters and cancer may have spread to nearby lymph nodes.

Stage 4: The tumor may be any size and cancer may have spread to nearby lymph nodes. Cancer has also spread to distant parts of the body such as the lung, bone marrow, or bone.

Grouping System

The grouping system is based on whether the cancer has spread and how much cancer remains after surgery to remove the tumor:

Group I: Cancer was found only in the place where it started and it was completely removed by surgery. Tissue was taken from the edges of where the tumor was removed. The tissue was checked under a microscope by a pathologist and no cancer cells were seen.

Group II is divided into groups IIA, IIB, and IIC: 

  • IIA: Cancer was removed by surgery but cancer cells were seen when the tissue, taken from the edges of where the tumor was removed, was viewed under a microscope by a pathologist.
  • IIB: Cancer had spread to nearby lymph nodes and the cancer and lymph nodes were removed by surgery.
  • IIC: Cancer had spread to nearby lymph nodes and the cancer and lymph nodes were removed by surgery. Tissue was taken from the edges of where the tumor was removed. The tissue was checked under a microscope by a pathologist and no cancer cells were seen.

Group III: Cancer was partly removed by surgery and there are cancer cells (a lump or mass) remaining that can be seen by x-ray or other imaging test. Cancer has not spread to distant parts of the body.

Group IV: Cancer had spread to distant parts of the body at the time of diagnosis.

Risk Group 

The risk group is based on the staging system and the grouping system and is used to plan treatment. It describes the chance that rhabdomyosarcoma will recur (come back). The following risk groups are used:

Low-risk rhabdomyosarcoma is one of the following:

  • An embryonal tumor of any size that is found in a "favorable" site. There may be tumor remaining after surgery that can be seen without a microscope. The cancer may have spread to nearby lymph nodes. The following areas are "favorable" sites:
     
    • Eye or area around the eye
    • Head or neck (but not in the tissue next to the brain and spinal cord)
    • Gallbladder and bile ducts
    • In the testes or vagina (but not in the kidney, bladder, or prostate)
  • An embryonal tumor of any size that is not found in one of the "favorable" sites listed above. There may be tumor remaining after surgery that can be seen only with a microscope. The cancer may have spread to nearby lymph nodes.

Intermediate-risk rhabdomyosarcoma is one of the following:

  • An embryonal tumor of any size that is not found in one of the "favorable" sites listed above. There is tumor remaining after surgery, that can be seen with or without a microscope. The cancer may have spread to nearby lymph nodes.
  • An alveolar tumor of any size in a "favorable" or "unfavorable" site. There may be tumor remaining after surgery that can be seen with or without a microscope. The cancer may have spread to nearby lymph nodes.

High-risk  rhabdomyosarcoma may be the embryonal type or the alveolar type. It may have spread to nearby lymph nodes and has spread to one or more distant parts of the body.

If your child has been diagnosed with rhabdomyosarcoma, we’re here to help. Call 1-877-632-6789 to make an appointment or request an appointment online.

Why Choose MD Anderson?

  • The Children’s Cancer Hospital is within the No. 1 cancer center in America
  • Access to novel therapies and state-of-the-art technologies before most children’s hospitals
  • We see more types of cancer than any other children’s hospital in Texas
  • Family-centered care that actively involves parents in their child’s treatment
  • A strong cancer research program focused on developing new therapies for pediatric patients
  • Comprehensive support services such as an accredited school program, creative arts, child life and career counseling
  • An Adolescent and Young Adult Program that specializes in the unique medical and psychological needs of patients aged 15-25

Rhabdomyosarcoma Knowledge Center

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