Abstract
Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children and adolescents and its occurrence in adults is extremely rare. There are three major subtypes of RMS of which alveolar RMS (ARMS) has the worst prognosis and tends to metastasize to unusual locations such as the pancreas. We present a case of a 19-year-old male with a rapidly enlarging right orbital mass, the imaging of which revealed it to be an infiltrative lesion with extension into the nasal cavity, ethmoid sinuses, and intracranial involvement. Histopathology confirmed the diagnosis of ARMS. A staging CT scan showed an enlarged and hypoenhancing pancreas; the histopathology test confirmed ARMS metastasis. It is important to consider pancreatic involvement in patients with ARMS, as it may be misinterpreted with other pathologies such as pancreatitis and pancreatic lymphoma. Metastasis to the pancreas can significantly alter the clinical approach and staging, underscoring the need for accurate diagnosis and staging in these patients.