Case Report-Rhabdomyosarcoma Masquerading Lymphoma

A 10year old male, resident of Ahmedabad, presented with a painless rapidly progressive swelling of left eye lower lid since past 1week. On examination, a well defined hard mass was palpated underlying lower lid. So he was clinically suspected to have Rhabdomyosarcoma. The patient was subjected to routine blood investigations. Ultrasonography of local area showed 5x3x1.5 mm sized well defined mixed echogenic lesion in left eye lower lid. In CT SCAN (Brain+orbit), extracalverial soft tissue swelling (HU: 45-50) in left infraorbital region with intraorbital extension was noted. An incisional biopsy was done via inferior conjunctival approach and sent for Histopathological examination (HPE) which showed possibility of undifferentiated malignant small round cell tumor with likely possibility of Embryonal Rhabdomyosarcoma. Further, for confirmation and typing, Immunohistochemistry (IHC) was done which revealed TDT, PAX-5, CD79a, CD20 positive Precursor B Lymphoblastic Lymphoma. So the patient was treated with cytoproductive Cyclophosphamide, Vincristine and Prednisolone.