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

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• 作者：Nicole Hassold (1)
  Monika Warmuth-Metz (2)
  Beate Winkler (3)
  Michael C Kreissl (4)
  Karen Ernestus (5)
  Meinrad Beer (1)
  Henning Neubauer (1)
  
• 关键词：Rhabdomyosarcoma ; Metastases ; Extraocular eye muscles ; DWI ; PET/CT
• 刊名：BMC Pediatrics
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：653 KB
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  10. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2431/14/57/prepub
  
• 作者单位：Nicole Hassold (1)
  Monika Warmuth-Metz (2)
  Beate Winkler (3)
  Michael C Kreissl (4)
  Karen Ernestus (5)
  Meinrad Beer (1)
  Henning Neubauer (1)
  
  1. Department of Paediatric Radiology, Institute of Diagnostic and Interventional Radiology, Josef-Schneider-Stra脽e 2, Wuerzburg, 97080, Germany
  2. Department of Neuroradiology, Institute of Diagnostic and Interventional Radiology, Josef-Schneider-Stra脽e 11, Wuerzburg, 97080, Germany
  3. Department of Paediatrics, Josef-Schneider-Stra脽e 2, Wuerzburg, 97080, Germany
  4. Department of Nuclear Medicine, Oberduerrbacher Stra脽e 6, Wuerzburg, 97080, Germany
  5. Institute of Pathology, Josef-Schneider-Stra脽e 2, Wuerzburg, 97080, Germany
  
• ISSN：1471-2431

文摘

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.