Botryoid Rhabdomyosarcoma of Biliary Tree - An Unusual Presentation of Obstructive Jaundice in a Child

Abstract

A 5-year-old male child presented with complaints of abdominal pain, swelling, yellowish discoloration of eyes and altered stools for 4 months. No h/o fever/similar complaints in family/recent vaccinations/recent travel/blood transfusion. Normal vaccination for age. Subsequently contrast enhanced computed tomography (CECT) of the patient was done and it showed – ill-defined heterogeneously enhancing mass lesion measuring 68 mm x 50 mm x 70 mm at the level of confluence of right and left hepatic duct with upstream dilatation of intra-hepatic biliary radicles. Lesion is seen encasing portal vein, hepatic artery with no evidence of tumour thrombosis. Moderate ascites, few heterogeneously enhancing nodules in peri-portal region and few enlarged lymph nodes noted at porta hepatis was observed.