PROMOTING ACCESS TO AFRICAN RESEARCH

SA Journal of Radiology

The AJOL site is currently undergoing a major upgrade, and there will temporarily be some restrictions to the available functionality.
-- Users will not be able to register or log in during this period.
-- Full text (PDF) downloads of Open Access journal articles will be available as always.
-- Full text (PDF) downloads of subscription based journal articles will NOT be available
We apologise for any inconvenience caused. Please check back soon, as we will revert to usual policy as soon as possible.





Embryonal rhabdomyosarcoma of the biliary tree in a paediatric patient – A rare cause of obstructive jaundice

Denny Mathew, Heliodora de Lima, Nasreen Mahomed

Abstract


Rhabdomyosarcoma (RMS) is the most common soft-tissue sarcoma in the paediatric age group, ranking fourth in frequency after central nervous system tumours, neuroblastomas and nephroblastomas. Embryonal RMS of the biliary tree is considered a rare entity, with the most common clinical presentation being that of obstructive jaundice. We present the case of a 4-year-old boy who presented with hepatomegaly and obstructive jaundice. Biochemically, there was evidence of elevated ductal enzymes with conjugated hyperbilirubinaemia. The magnetic resonance imaging (MRI) features were consistent with a biliary RMS with the differential diagnosis of a choledochal cyst initially included based on the computed tomography images. The diagnosis of embryonal biliary RMS was later confirmed on histology. This case illustrates the importance of considering malignant aetiologies in paediatric cases of obstructive jaundice, as this entity is infrequently described in the literature and may mimic the appearance of a choledochal cyst. The demonstration of enhancement of intraductal material within the biliary tree on MRI and the presence of arterial waveforms within the intraductal mass on ultrasound assists in the differentiation between biliary RMS and a choledochal cyst.




AJOL African Journals Online