A Rare Presentation of Embryonal Rhabdomyosarcoma of Broad Ligament Mimicking Pelvic Teratoma

Abstract

Embryonal rhabdomyosarcoma (EMRS) accounts for 60% of all rhabdomyosarcomas, with an incidence of 2.6 per million in U.S. children under 15. It mainly affects those under 10, though it can occur in adolescents and young adults. Common sites include the head, neck, genitourinary tract, extremities, pelvis, and retroperitoneum. A 4-year-old girl presented with abdominal distension and absence of bowel motion, with a brief episode of abdominal pain a month prior. Imaging revealed a large cystic mass in the abdominopelvic region, initially suspected to be an ovarian teratoma. Surgery found a highly vascular mass, which biopsy confirmed as EMRS. Chemotherapy reduced the tumor but caused moderate hydronephrosis. A second surgery successfully removed the mass attached to the urinary bladder. The patient recovered well and continued chemotherapy to complete her treatment.