title: Role of magnetic resonance imaging in the early diagnosis of paratesticular rhabdomyosarcoma.
abstract: BACKGROUND
  Paratesticular lesions are common, and one subgroup is paratesticular rhabdomyosarcoma. The latter is a relatively uncommon (but aggressive) tumour that affects children and adolescents predominantly. Ultrasound is the first-line investigation, but can be inconclusive. Magnetic resonance imaging (MRI) can provide useful information, but its role in the diagnosis of rhabdomyosarcoma is not clear.
  
  
  METHODS
  We report a 17-year-old male who presented with a one-month history of a rapidly enlarging, non-tender, lump in the right testicle. Urgent ultrasound of the scrotum revealed a heterogenous paratesticular mass that was hypervascular and showed calcification in the right inguinal area. MRI of the pelvis showed a solid, enhancing lesion of dimension located superior to the upper pole of the right testes and a slightly heterogeneous T2 signal, but was homogenous post-contrast. The patient underwent right radical orchidectomy, and histology results were assessed. He received chemotherapy and is being followed up.
  
  
  CONCLUSIONS
  Improvements in imaging in addition to early surgical intervention and chemotherapy treatment are crucial to improve survival chances against rhabdomyosarcoma. Ultrasound findings for benign diseases may mimic those seen in rhabdomyosarcoma. In such cases of diagnostic uncertainty, our surgical team suggest MRI to reduce the risk of a delayed diagnosis and time to treatment.
authors.affiliation: Medway Maritime Hospital , Gillingham , UK.
authors.forename: T
authors.initials: T
authors.lastname: Shah
authors.affiliation: Medway Maritime Hospital , Gillingham , UK.
authors.forename: O
authors.initials: O
authors.lastname: Abu-Sanad
authors.affiliation: Medway Maritime Hospital , Gillingham , UK.
authors.forename: H
authors.initials: H
authors.lastname: Marsh
mesh_terms: D000293:Adolescent; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009919:Orchiectomy; D012208:Rhabdomyosarcoma / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy
keywords: Chemotherapy; Histology; Magnetic resonance imaging; Paratesticular lesions; Rhabdomyosarcoma; Ultrasound