Abstract
BACKGROUND: Rhabdomyosarcoma (RMS) is a malignant childhood tumor that most commonly involves the skeletal muscles of the head and neck, genitourinary tract, limbs, and, rarely, the spine. CASE DESCRIPTION: A 19-year-old male presented with cauda equina symptoms. Magnetic resonance imaging showed a C7/T1 homogeneously enhancing lesion, causing pathological fracture of the T1. Similar lesions were found on T3 and S1-S2 levels. CT-guided biopsy and immunohistochemistry confirmed the diagnosis of highly malignant alveolar RMS. He underwent multi-level laminectomies with partial tumor debulking but was paraplegic postoperatively. CONCLUSION: Spinal RMS rarely involves the soft tissues of the spine and should be surgically resected if feasible. Nevertheless, the long-term prognosis is poor regarding tumor recurrence and metastases.