Incidental Discovery of Embryonal Rhabdomyosarcoma on CT Imaging

Rhabdomyosarcoma is an uncommon soft tissue sarcoma that rarely presents in adults. Clinical presentation is dependent on site and size. We present the case of a woman who presented with acute-onset dyspnoea and whose pathology report confirmed embryonal rhabdomyosarcoma (ERMS) seen as an incidental finding on chest computed tomography. We also describe the clinical, laboratory and radiological work-up conducted to diagnose and manage ERMS in the critical care setting. LEARNING POINTS: Rhabdomyosarcoma is a rare malignancy with a poor prognosis in adults compared with children, especially if it presents in an unfavourable primary site and has an unfavourable histological diagnosis. Immunohistochemical diagnosis remains the gold standard for embryonal rhabdomyosarcoma diagnosis and differentiation from similar malignancies on initial imaging studies. Management of adult rhabdomyosarcoma is usually multimodal with surgical resection and a combination of chemo and radiotherapy.