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Rhabdomyosarcoma presenting as intramuscular haematoma due to brachioradialis tear after trauma
  1. Daniel Warden,
  2. Kamil Cieply,
  3. Brandon Armstrong and
  4. Michelle Nelson
  1. Family Medicine, Michigan State University/MyMichigan Medical Center Alma, Alma, Michigan, USA
  1. Correspondence to Dr Michelle Nelson; michelle.nelson{at}


A man in his 40s with a history of neurofibromatosis type 1 presented to the emergency department with worsening anterior elbow pain and swelling after falling from a chair 2 months prior. An X-ray showed soft tissue swelling without fracture and the patient was diagnosed with a rupture of the biceps muscle. MRI of the right elbow showed a brachioradialis tear with a large haematoma along the humerus. This was initially thought to be a haematoma; therefore, wound evacuation was done twice. When the injury failed to resolve, a tissue biopsy was performed. This revealed a grade 3 pleomorphic rhabdomyosarcoma. It is important to consider malignancy in the differential diagnosis with rapidly growing masses even if the initial presentation is suggestive of a benign condition. Neurofibromatosis type 1 is also associated with a higher risk of malignancy than the general population.

  • Oncology
  • Orthopaedics

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  • DW and MN are joint first authors.

  • Contributors DW was the lead author for this case report, making significant writing contributions to the manuscript. MN was actively involved in patient treatment decisions, oversight of the manuscript and spending a significant time writing and editing the manuscript. KC was involved in the care of the patient, interviewing the patient for patient’s perspective and writing sections of the manuscript. BA was involved in portions of writing the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.