Virginia Commonwealth University

VCU Massey Cancer Center

How is rhabdomyosarcoma diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for rhabdomyosarcoma may include the following methods:

  • Biopsy of the tumor – when a sample of tissue is removed from the tumor and examined under a microscope.
  • Blood and urine tests
  • Multiple imaging studies:
    • Computed tomography scan (also called a CT or CAT scan) – a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs. CT scans are more detailed than general X-rays.
    • Magnetic resonance imaging – a diagnostic procedure that uses a combination of large magnets, radio frequencies and a computer to produce detailed images of organs and structures within the body.
    • X-ray – a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs onto film.
    • Ultrasound (also called sonography) – a diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues and organs. Ultrasounds are used to view internal organs as they function and to assess blood flow through various vessels.
    • Bone scans – pictures or X-rays taken of the bone after a dye has been injected that is absorbed by bone tissue. These scans are used to detect tumors and bone abnormalities.
  • Bone marrow aspiration and/or biopsy – a procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size and maturity of blood cells and/or abnormal cells.
  • Lumbar puncture/spinal tap – a special needle is placed into the lower back into the spinal canal (the area around the spinal cord). The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid can be removed and sent for testing to determine if there is an infection or other problems. Cerebral spinal fluid is the fluid that bathes your child’s brain and spinal cord.

Diagnosis involves staging and classifying the tumor, which is important in determining treatment options.

What are the stages of rhabdomyosarcoma?

Staging is the process of finding out whether cancer has spread and, if so, how far. There are various staging systems that are used for rhabdomyosarcoma. Always consult your child’s physician for more information on staging. One method of staging is the TNM staging system. This system uses tumor (T), nodes (N) and metastases (M) to differentiate the disease by stages. This system evaluates the disease before surgery and classifies it by one of the four following stages:

  • Stage I – tumors involving the area near the eye, head, neck and genitourinary tract (except the prostate and bladder). The tumor is localized, meaning the tumor has not spread to other areas of the body.
  • Stage II – small, localized tumors less than 5 cm in any site not in stage I. There are no tumor cells in the surrounding lymph nodes. 
  • Stage III – localized tumor at any site not included in stage I that is larger than 5 cm and/or has spread to surrounding lymph nodes. 
  • Stage IV – disease that has spread to other areas of the body at the time of diagnosis.