Zhu Jingqi, Zhang Jianhua, Tang Guangyu, Hu Shiyou, Zhou Guoxing, Liu Yongkang, Dai Lingling, Wang Zhongqiu
Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China ; Department of Radiology, East Hospital, Tongji University School of Medicine, Shanghai 200120, P.R. China.
Department of Radiology, East Hospital, Tongji University School of Medicine, Shanghai 200120, P.R. China.
Oncol Lett. 2014 Jul;8(1):155-160. doi: 10.3892/ol.2014.2094. Epub 2014 Apr 25.
Head and neck (HN) rhabdomyosarcoma (RMS) is an aggressive malignancy, which is rarely encountered and is commonly misdiagnosed as another type of tumor. The aim of the present study was to investigate the computed tomography (CT) and magnetic resonance imaging (MRI) features of HNRMS and analyze the correlations between the imaging observations and the pathological subtypes. A total of 10 HNRMS patients (three males and seven females; median age, 16 years) were reviewed retrospectively by only CT (n=1), only MRI (n=2), as well as CT and MRI (n=7). In addition, the clinical data, imaging observations and pathological results were recorded and analyzed. The origins of the 10 HNRMSs (eight embryonal and two alveolar subtypes) included the ethmoid sinus (n=4), maxillary sinus (n=1), orbit (n=3), nasopharynx (n=1) and frontotemporal subcutaneous area (n=1). On the CT and MRI images, the soft-tissue masses exhibited ill-defined borders (n=9), bony destruction (n=10), multi-cavity growth (n=7) and cervical lymph node metastasis (n=2), whereas calcification and hemorrhaging were not identified. On CT, eight of the HNRMSs appeared slightly hypodense (2/8) or isodense (6/8) with homogeneous enhancement (4/4). On T1-weighted images (WI), nine tumors exhibited isointensity (9/9) and on T2WI, six tumors demonstrated homogeneous hyperintensity with homogeneous enhancement on contrast-enhanced (CE)-T1WI. In addition, three embryonal RMSs, which originated from the ethmoid sinus, exhibited heterogeneous hyperintensity on T2WI and nodule-shaped enhancement patterns on CE-T1WI. The results of the present study indicated that MRI may accurately demonstrate the location and extent of HNRMS and that the imaging features of HNRMS may be similar to those of other tumors. However, a tumor exhibiting heterogeneous hyperintensity on T2WI and a nodule-shaped enhancement pattern on CE-T1WI in the ethmoid sinus may present specific MRI features, which clearly indicates the botryoid subtype of embryonal RMS.
头颈部（HN）横纹肌肉瘤（RMS）是一种侵袭性恶性肿瘤，临床罕见且常被误诊为其他类型的肿瘤。本研究旨在探讨头颈部横纹肌肉瘤的计算机断层扫描（CT）和磁共振成像（MRI）特征，并分析影像学表现与病理亚型之间的相关性。本研究回顾性分析了10名头颈部横纹肌肉瘤患者（3例男性，7例女性；中位年龄16岁），其中仅行CT检查的有1例，仅行MRI检查的有2例，同时行CT和MRI检查的有7例。此外，记录并分析了患者的临床资料、影像学表现和病理结果。这10例头颈部横纹肌肉瘤（8例胚胎型和2例肺泡型）的起源部位包括筛窦（4例）、上颌窦（1例）、眼眶（3例）、鼻咽部（1例）和额颞部皮下区域（1例）。在CT和MRI图像上，软组织肿块边界不清（9例）、骨质破坏（10例）、呈多腔生长（7例）以及颈部淋巴结转移（2例），未发现钙化和出血。在CT上，8例头颈部横纹肌肉瘤表现为稍低密度（2/8）或等密度（6/8），增强扫描呈均匀强化（4/4）。在T1加权像（WI）上，9个肿瘤呈等信号（9/9），在T2WI上，6个肿瘤呈均匀高信号，增强扫描T1WI呈均匀强化。此外，3例起源于筛窦的胚胎型横纹肌肉瘤在T2WI上呈不均匀高信号，增强扫描T1WI呈结节状强化。本研究结果表明，MRI可准确显示头颈部横纹肌肉瘤的位置和范围，其影像学表现可能与其他肿瘤相似。然而，筛窦内肿瘤在T2WI上呈不均匀高信号且增强扫描T1WI呈结节状强化可能具有特异性MRI表现，这明确提示胚胎型横纹肌肉瘤的葡萄状亚型。
