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Case Reports
. 2013 Sep 14;6(3):472-9.
doi: 10.1159/000355250. eCollection 2013.

Rare adult masseteric rhabdomyosarcoma and a review of the literature

T Franco  1 , A La Boria, R Domanico, G L Piazzetta, G Donato, E Allegra
Affiliations
Case Reports

Rare adult masseteric rhabdomyosarcoma and a review of the literature

T Franco et al. Case Rep Oncol. .

Abstract

Background: Rhabdomyosarcomas (RMSs) are a group of soft-tissue malignant tumors which derive from primitive skeletal muscle tissue that mainly affect children and adolescents. RMSs are very rare in adults, where they are usually located in the extremities.

Case presentation: A previously healthy 32-year-old male presented at our ENT (ear, nose and throat) outpatient clinic after experiencing a parotid region swelling for 2 months. The patient was treated surgically by excising the mass and by modified radical ipsilateral neck dissection. Histological and immunohistochemical examination indicated masseteric alveolar RMS with lymphatic metastasis. The patient received radiochemotherapy, and he is still alive with no evidence of disease spread 1 year after diagnosis.

Conclusion: This is the first case of a masseter alveolar RMS to be reported in the literature in a patient older than 25 years; it highlights the broad spectrum of neoplasms that cause parotid region swellings and the importance of considering rare tumors during differential diagnosis.

Keywords: Adult rhabdomyosarcoma; Alveolar rhabdomyosarcoma; Head and neck rhabdomyosarcoma; Masseter neoplasm.

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Figures

Fig. 1
Fig. 1
Multislice CT showing the mass in the right masseter with central necrosis and perifocal inflammatory reaction, associated with thickening of the masseter muscle.
Fig. 2
Fig. 2
Multislice CT. Coexisting[T1] areas of high enhancement are visible at the lower parotid pole with multiple cervical lymphadenopathies at the level III and IV cervical nodes.
Fig. 3
Fig. 3
MRI showing an oval mass in the right masseter muscle, which was mildly hyperintense in T1-weighted images and hyperintense in long TR, with regular margins and a high contrast intake.
Fig. 4
Fig. 4
PET. Pathological increase in glucose metabolism in the intramasseteric right region (SUV max 10.5), right jugular nodes, right submandibular nodes (SUV max 6.6), and right cervical nodes (SUV max 6.7).
Fig. 5
Fig. 5
Histopathological and immunohistochemical features of alveolar RMS. Hematoxylin and eosin stain (40×): small and intermediate-sized round tumor cells are visibly separated by connective tissue septa.
Fig. 6
Fig. 6
Histopathological and immunohistochemical features of alveolar RMS. Widespread nuclear immunoreactivity against myogenin (40×).
See this image and copyright information in PMC

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