Hit the mark with diffusion-weighted imaging: metastases of rhabdomyosarcoma to the extraocular eye muscles

BMC Pediatrics

Henning Neubauer³  Meinrad Beer³  Karen Ernestus²  Michael C Kreissl¹  Beate Winkler⁴  Monika Warmuth-Metz⁵  Nicole Hassold³ 

[1] Department of Nuclear Medicine, Oberduerrbacher Straße 6, Wuerzburg 97080, Germany;Institute of Pathology, Josef-Schneider-Straße 2, Wuerzburg 97080, Germany;Department of Paediatric Radiology, Institute of Diagnostic and Interventional Radiology, Josef-Schneider-Straße 2, Wuerzburg 97080, Germany;Department of Paediatrics, Josef-Schneider-Straße 2, Wuerzburg 97080, Germany;Department of Neuroradiology, Institute of Diagnostic and Interventional Radiology, Josef-Schneider-Straße 11, Wuerzburg 97080, Germany

关键词: PET/CT;    DWI;    Extraocular eye muscles;    Metastases;    Rhabdomyosarcoma;   

Others  :  1138985
DOI  :  10.1186/1471-2431-14-57

 received in 2013-07-19, accepted in 2014-02-24,  发布年份 2014

【 摘 要 】

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.

【 授权许可】

   
2014 Hassold et al.; licensee BioMed Central Ltd.

【 图 表 】

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