Pediatric Nursing Demystified

Rhabdomyosarcoma

What Went Wrong?

Arhabdomyosarcomais the fourth most common solid tumor. It arises from

the embryonic mesenchyme tissue that forms connective, vascular, muscle, and

connective tissue. The primary sites of occurrence are the ocular orbit, paranasal

sinuses, uterus, prostate, bladder, retroperitoneum, arms, or legs. Metastasis into

the CNS occurs in addition to distant metastasis commonly to the lungs, bone,

or the bone marrow. Rhabdomyosarcoma may occur at any age but occurs pri-

marily in children <5 years of age with a second peak incidence during puberty.

Signs and Symptoms

Common assessment findings:

• Symptoms depend on the site and stage of the tumor:
  Unilateral proptosis (exophthalmos), strabismus, and conjunctival
  ecchymosis are noted with metastasis to the eye orbit.
  Palpable nontender, firm, hard mass in head and neck area.
  Stuffy nose, nasal obstruction (dysphagia, nasal voice, and otitis
  media due to eustachian tube obstruction) with nasopharynx or
  paranasal tumor or middle ear tumor (pain, purulent drainage, and
  facial nerve palsy).
  Abdominal mass (retroperitoneal) or superficial perineal mass with
  pain, or signs of bowel or bladder obstruction: Intestinal (nausea/
  vomiting) or genitourinary (urinary retention or frequency).

Test Results

Diagnosis by biopsy to confirm histologic type.

Bone scan, chest radiograph, CT scan, MRI, and bone marrow aspirations

done to rule out metastasis.

(^168) Pediatric Nursing Demystified

1. There are ____stages of ____ to be considered when plan-
   ning with parents of children with a terminal cancer diagnosis.
   Answer:


2. Neuroblastoma, neoplasm, retinoblastoma, and osteosarcoma are all examples of
   solid tumors. True or false?
   Answer:

✔ ROUTINE CHECKUP 4