Hit the mark with diffusion-weighted imaging: metastases of rhabdomyosarcoma to the extraocular eye muscles
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Hit the mark with diffusion-weighted imaging: metastases of rhabdomyosarcoma to the extraocular eye muscles. / Hassold, Nicole; Warmuth-Metz, Monika; Winkler, Beate; Kreissl, Michael C; Ernestus, Karen; Beer, Meinrad; Neubauer, Henning.
in: BMC PEDIATR, Jahrgang 14, 27.02.2014, S. 57.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › Case Report › Forschung › Begutachtung
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TY - JOUR
T1 - Hit the mark with diffusion-weighted imaging: metastases of rhabdomyosarcoma to the extraocular eye muscles
AU - Hassold, Nicole
AU - Warmuth-Metz, Monika
AU - Winkler, Beate
AU - Kreissl, Michael C
AU - Ernestus, Karen
AU - Beer, Meinrad
AU - Neubauer, Henning
PY - 2014/2/27
Y1 - 2014/2/27
N2 - BACKGROUND: Rhabdomyosarcoma is the most frequent malignant intraorbital tumour in paediatric patients. Differentiation of tumour recurrence or metastases from post-therapeutic signal alteration can be challenging, using standard MR imaging techniques. Diffusion-weighted MRI (DWI) is increasingly considered a helpful supplementary imaging tool for differentiation of orbital masses.CASE PRESENTATION: We report on a 15-year-old female adolescent of Caucasian ethnicity who developed isolated bilateral thickening of extraocular eye muscles about two years after successful multimodal treatment of orbital alveolar rhabdomyosarcoma. Intramuscular restricted diffusion was the first diagnostic indicator suggestive of metastatic disease to the eye muscles. DWI subsequently showed signal changes consistent with tumour progression, complete remission under chemoradiotherapy and tumour recurrence.CONCLUSIONS: Restricted diffusivity is a strong early indicator of malignancy in orbital tumours. DWI can be the key to correct diagnosis in unusual tumour manifestations and can provide additional diagnostic information beyond standard MRI and PET/CT. Diffusion-weighted MRI is useful for monitoring therapy response and for detecting tumour recurrence.
AB - BACKGROUND: Rhabdomyosarcoma is the most frequent malignant intraorbital tumour in paediatric patients. Differentiation of tumour recurrence or metastases from post-therapeutic signal alteration can be challenging, using standard MR imaging techniques. Diffusion-weighted MRI (DWI) is increasingly considered a helpful supplementary imaging tool for differentiation of orbital masses.CASE PRESENTATION: We report on a 15-year-old female adolescent of Caucasian ethnicity who developed isolated bilateral thickening of extraocular eye muscles about two years after successful multimodal treatment of orbital alveolar rhabdomyosarcoma. Intramuscular restricted diffusion was the first diagnostic indicator suggestive of metastatic disease to the eye muscles. DWI subsequently showed signal changes consistent with tumour progression, complete remission under chemoradiotherapy and tumour recurrence.CONCLUSIONS: Restricted diffusivity is a strong early indicator of malignancy in orbital tumours. DWI can be the key to correct diagnosis in unusual tumour manifestations and can provide additional diagnostic information beyond standard MRI and PET/CT. Diffusion-weighted MRI is useful for monitoring therapy response and for detecting tumour recurrence.
KW - Adolescent
KW - Diffusion Magnetic Resonance Imaging
KW - Female
KW - Humans
KW - Muscle Neoplasms/diagnosis
KW - Oculomotor Muscles
KW - Orbital Neoplasms/pathology
KW - Rhabdomyosarcoma/diagnosis
U2 - 10.1186/1471-2431-14-57
DO - 10.1186/1471-2431-14-57
M3 - Case report
C2 - 24575889
VL - 14
SP - 57
JO - BMC PEDIATR
JF - BMC PEDIATR
SN - 1471-2431
ER -
