{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T06:14:02Z","timestamp":1788156842720,"version":"build-2803163510"},"reference-count":13,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Paratesticular rhabdomyosarcoma is a rare malignancy in children and adolescents that frequently presents diagnostic challenges when mimicking benign inflammatory conditions. We report the case of a 14\u2010year\u2010old previously healthy male who presented with acute right scrotal pain and swelling initially diagnosed as epididymo\u2010orchitis. Despite 1\u2009month of intensive antibiotic therapy including intravenous meropenem, the patient showed no clinical improvement. Serial ultrasound examinations demonstrated a heterogeneous paratesticular mass with increased vascularity, prompting MRI evaluation that revealed an 8\u2009\u00d7\u20096.4\u2009\u00d7\u20099.5\u2009cm heterogeneous enhancing mass. CT staging showed prominent para\u2010aortic and inguinal lymph nodes without distant metastases. The patient underwent radical inguinal orchiectomy, and histopathology confirmed embryonal rhabdomyosarcoma with spindle cell features and focal anaplasia. Immunohistochemistry demonstrated positive staining for desmin and myogenin, confirming skeletal muscle differentiation. The patient was referred for multimodal chemotherapy according to Children's Oncology Group protocols. This case highlights the critical importance of maintaining high clinical suspicion for paratesticular malignancy when pediatric scrotal masses fail to respond to appropriate antibiotic therapy, as diagnostic delays can significantly impact staging and treatment outcomes.<\/jats:p>","DOI":"10.1002\/ccr3.73219","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T04:18:52Z","timestamp":1785557932000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Paratesticular Embryonal Rhabdomyosarcoma Masquerading as Epididymitis: A Diagnostic Challenge in Adolescents"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6465-7418","authenticated-orcid":false,"given":"Saif Khaled Abdalhadi","family":"Azzam","sequence":"first","affiliation":[{"name":"Department of Clinical Medical Sciences, Faculty of Medicine and Health Sciences Palestine Polytechnic University  Hebron West Bank Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina Barhoum","family":"Barhoum","sequence":"additional","affiliation":[{"name":"Department of Clinical Medical Sciences, Faculty of Medicine and Health Sciences Palestine Polytechnic University  Hebron West Bank Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8490-3149","authenticated-orcid":false,"given":"Ammir","family":"Abuzahra","sequence":"additional","affiliation":[{"name":"College of Medicine, Hebron University  Hebron West Bank Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Alazzeh","sequence":"additional","affiliation":[{"name":"College of Medicine, Hebron University  Hebron West Bank Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khader","family":"Hassouneh","sequence":"additional","affiliation":[{"name":"Department of Clinical Medical Sciences, Faculty of Medicine and Health Sciences Palestine Polytechnic University  Hebron West Bank Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nour Aldin K.","family":"Fakhory","sequence":"additional","affiliation":[{"name":"Department of Clinical Medical Sciences, Faculty of Medicine and Health Sciences Palestine Polytechnic University  Hebron West Bank Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd Othman","family":"Lafi","sequence":"additional","affiliation":[{"name":"Department of Clinical Medical Sciences, Faculty of Medicine and Health Sciences Palestine Polytechnic University  Hebron West Bank Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. I.","family":"Jawabreh Issa","sequence":"additional","affiliation":[{"name":"Department of Clinical Medical Sciences, Faculty of Medicine and Health Sciences Palestine Polytechnic University  Hebron West Bank Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Alzatari","sequence":"additional","affiliation":[{"name":"Radiology Department Al\u2010Ahli Hospital  Hebron West Bank Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza","family":"Zughaier","sequence":"additional","affiliation":[{"name":"Department of Pathology Al\u2010Ahli Hospital  Hebron West Bank Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"e_1_2_14_2_1","volume-title":"Childhood Rhabdomyosarcoma Treatment (PDQ): Health Professional Version","author":"PDQ Pediatric Treatment Editorial Board","year":"2002"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.5114\/WO.2015.52661"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.20.2.449"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000011164"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/S12913\u2010020\u201005532\u20108"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1089\/JAYAO.2011.0016"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.5534\/WJMH.2012.30.2.146"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/JSCR\/RJAF166"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/FONC.2021.629878"},{"key":"e_1_2_14_11_1","article-title":"A Case Report of Paratesticular Rhabdomyosarcoma in an Adolescent","volume":"1","author":"Shazly A. 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