Epididymal spindle cell rhabdomyosarcoma in a 16-year-old boy: a rare case report and literature review

Introduction: Epididymal spindle cell rhabdomyosarcoma is a rare malignant tumor in children, often presenting as a slow-growing, painless mass. Although computerized tomography (CT) and magnetic resonance imaging have value in the diagnosis of epididymal rhabdomyosarcoma, they lack specificity. The final diagnosis still relies on pathological results. Case presentation: We report on a 16-year-old boy who underwent surgery for a solid mass in the left scrotum. During the operation, it was found that the tumor attachment site was limited to the tail of the epididymis. The testis, spermatic cord, or tunica were not involved. Microscopic examination revealed the tumor to be composed of spindle-shaped cells, consistent with a diagnosis of rhabdomyosarcoma. TNM staging was T 1 NxM 0. No radiotherapy or chemotherapy was performed after surgery. From the surgery until now, we have been following up with the patient. The patient has not reported any discomfort. Discussion: Rhabdomyosarcoma refers to a malignant tumor that originates from striated muscle cells or mesenchymal cells that differentiate into striated muscle cells. It is a common malignant tumor in children and is more common in the head, neck, trunk, limbs, and urogenital system. Rhabdomyosarcoma originating from the epididymis is clinically rare. Conclusion: Epididymal spindle cell rhabdomyosarcoma is a rare disease, often discovered incidentally. Without a histological result, the diagnosis of epididymal spindle cell rhabdomyosarcoma may not be possible. This report may provide new aspects of the visualization of epididymal spindle cell rhabdomyosarcoma and highlight the necessity to upgrade the diagnostic approach.