Bilateral recurrent adult rhabdomyomas of the pharyngeal wall

Adult rhabdomyomas of the head and neck are uncommon benign skeletal muscle tumors. Only a few cases occurring in the pharyngeal wall have been described in the world literature. We present a case of recurrent bilateral rhabdomyomas in the pharynx and discuss the clinicopathological features of this lesion, comparing it to those of other neoplasms from which it must be differentiated. To our knowledge, bilaterality of this type of lesion has not been described previously. Although adult rhabdomyomas have a distinct histology, they often are mistaken for a variety of other lesions, particularly granular cell tumor. Received: 20 July 1998 / Accepted: 4 March 1999     

Multifocal adult rhabdomyoma of the head and neck: a case report and literature review

Adult extracardiac rhabdomyomas are rare benign skeletal muscle tumors that most commonly present in the head and neck region. Only a few multifocal cases have been described to date in the world literature. We hereby present an additional multifocal case, the 14th worldwide, and review the literature.     

Adult rhabdomyoma in the parapharyngeal space: report of 2 cases and review of the literature

Rhabdomyomas are rare benign mesenchymal tumors with skeletal muscle differentiation. They are less commonly encountered than are their malignant counterparts, rhabdomyosarcomas. Rhabdomyomas fall into 2 general categories: cardiac and extracardiac types. Extracardiac rhabdomyomas are among the rarest tumors in humans and can be subclassified as fetal, juvenile, and adult types depending on the individual tumor's degree of differentiation by light microscopy. Adult extracardiac rhabdomyoma has a strong predilection for occurrence in the head and neck, mainly in the area of larynx and pharynx. In this article, 2 cases of parapharyngeal rhabdomyoma are reported together with a review of the world literature.     

Rhabdomyoma of the cricopharyngeus in an infant

Rhabdomyoma is a rare benign tumor characterized histologically by striated skeletal muscle. Rhabdomyomas can be classified into adult and fetal variants. The majority of adult variants arise in the head and neck region and are derived from the skeletal muscles of the pharyngeal (branchial) arches. The majority of cases of fetal variant rhabdomyomas have been described in the postauricular region of young children and the vulvovaginal region in middle-aged women. We present a case of a 15-month-old infant with a circumferential rhabdomyoma of the cricopharyngeus muscle requiring excision of the esophageal inlet and reconstruction with a free microvascular jejunal interposition graft. This case represents the youngest reported case of adult variant rhabdomyoma. The clinical, radiographic, and histologic findings of this unusual case and a review of reported cases of rhabdomyoma in the pediatric population will be presented.     

Fetal rhabdomyoma of the posterior cervical triangle

Rhabdomyoma is an uncommon benign tumor, with the majority arising from cardiac muscle. Seventy to 90% of extracardiac rhabdomyomas are found in the head and neck region, usually within the upper aerodigestive tract. The case of a 7-month-old boy with an enlarging posterior triangle neck mass found to be fetal rhabdomyoma is presented. This location is quite rare for benign rhabdomyoma, with previous literature search showing overwhelming predilection for the upper aerodigestive tract.     

A rare case of rhabdomyoma of the larynx causing airway obstruction

Rhabdomyomas are benign tumors of skeletal muscle derivation. Rhabdomyomas of the head and neck are unusual, and laryngeal rhabdomyomas of the adult type are rare. When they do occur, patients may present with symptoms that have progressed slowly over several years. In extraordinary cases, stridor and airway obstruction manifest. We report a case of adult rhabdomyoma of the larynx that features some of its typical and atypical presenting characteristics. This case also exemplifies the favorable prognosis that results following complete yet conservative surgical excision.     

Adult multilocular rhabdomyoma as etiology of a space-occupying lesion in the area of the neck

Real rhabdomyomas belong to the rarest tumors in the human body. The origin of these benign neoplasms is in the cardiac or skeletal muscle. In the beginning, there are no significant symptoms and the tumor grows very slowly. Extracardiac rhabdomyomas seldom occur and are mostly located in the head and neck region. A multilocular occurrence represents a rarity. We describe a 77-year-old female patient with a multilocular adult rhabdomyoma in the parapharyngeal and paratracheal space. The tumor was accidentally found; the patient had not complained of any specific symptoms. After histological examination, complete resection was carried out. On discharge the patient showed no functional deficits. Long-term follow-up is necessary because local recurrences have been described.     

Adult multilocular rhabdomyoma as a rare cause of dysphagia

BACKGROUND: Adult rhabdomyoma is a benign tumor of the cardial und skeletal muscle system. Besides intracardiac rhabdomyomas, extracardiac localization as the head and neck region is seldom; multilocular appearance is rare. CASE: We report about a 45 year old male patient with dysphagia and a slowly progredient expansion lesion in the left neck region. After complete surgical resection, histological investigation confirmed the diagnosis of a multilocular adult rhabdomyoma. CONCLUSION: Rhabdomyoma as a benign lesion could occur multilocular and simulate metastasis of a malign formation. To prevent local recurrent appearance, complete surgical resection is the best therapeutical option.     

Recurrent fetal rhabdomyoma of the head and neck

We present a case of a congenital fetal rhabdomyoma which recurred after surgical excision. A review of the patient's chart, imaging studies, operative reports and histologic findings were conducted. A congenital fetal rhabdomyoma involving the head and neck region diagnosed prenatally by ultrasound and MRI was surgically excised without complications. The patient presented with recurrence of the tumor fourteen months after the initial surgery. This case report is supplemented with a review of the relevant literature on congenital fetal rhabdomyoma. This is the fifth documented case of recurrence of a fetal rhabdomyoma. Extracardiac rhabdomyomas are extremely rare benign tumors. Complete excision of these lesions is curative with only a handful of recurrences documented in the literature. Close follow up and a complete workup to rule out rhabdomyosarcoma is warranted in all cases of recurrence.     

Multifocal adult rhabdomyoma: a case report and literature review

Adult extracardiac rhabdomyoma is an uncommon primary tumor of striated muscle origin that almost exclusively presents in the head and neck region. The occurrence of multifocality is a rare manifestation of this unusual lesion. In this study, we report a rare case of multifocal adult extracardiac rhabdomyoma in a patient presenting with an asymptomatic neck mass and provide a brief review of the literature on this entity.     

Pharyngeal rhabdomyoma: a clinico-pathological study.

Adult extracardiac rhabdomyomas are rare with only 33 head and neck cases being reported in the world literature. In this select group, only nine cases have been found in the pharynx. We present two cases of pharyngeal rhabdomyoma focusing on the imaging findings, surgical approaches and more specifically on the histopathological and electron microscopic diagnosis of this interesting lesion. It is important to differentiate this tumor from other neoplasms, including granular cell myoblastoma, rhabdomyosarcomas, hamartomas, and fetal rhabdomyomas.     

Rhabdomyoma of the larynx recurring after 12 years: immunocytochemistry and differential diagnosis

Summary Rhabdomyoma is a rare tumor of skeletal muscle origin which can occur in different localizations. The head and neck region is a site of predilection for the adult type. Its absolutely benign behavior makes correct diagnosis crucial. In this study, a case of an extracardiac rhabdomyoma of the larynx was found to recur 12 years after initial treatment. Following its surgical removal, histology showed typical patterns of an adult type of rhabdomyoma with focal cross-striations. Immunocytochemically, all applied muscular markers were positive. Electron microscopy revealed muscular filaments with cross-striations and glycogen granules. These findings showed that immunocytochemistry plays an important role in differential diagnosis and the need for possible further treatment.     

Rhabdomyoma of the larynx recurring after 12 years: immunocytochemistry and differential diagnosis

Rhabdomyoma is a rare tumor of skeletal muscle origin which can occur in different localizations. The head and neck region is a site of predilection for the adult type. Its absolutely benign behavior makes correct diagnosis crucial. In this study, a case of an extracardiac rhabdomyoma of the larynx was found to recur 12 years after initial treatment. Following its surgical removal, histology showed typical patterns of an adult type of rhabdomyoma with focal cross-striations. Immunocytochemically, all applied muscular markers were positive. Electron microscopy revealed muscular filaments with cross-striations and glycogen granules. These findings showed that immunocytochemistry plays an important role in differential diagnosis and the need for possible further treatment.     

Multifocal adult rhabdomyoma of the head and neck: a case report and literature review

Adult rhabdomyoma is a rare, usually solitary, primary tumour of striated muscle origin that almost exclusively presents in the head and neck region with predilection for male. We herein present a rare case of a multifocal adult rhabdomyoma in a 72-year-old woman. The lesions were located, the first one in the area of the left aryepiglottic fold and the second one right cervical arising from oesophagus. The diagnosis of the cervical mass was obtained prior to resection through cytological examination (FNAC). We discuss the clinical, cytological and histological findings and we provide a brief review of the literature on this entity.     

Glomus intravagale

Glomus intravagale (paraganglioma of the nodose ganglion and/or vagus nerve) is an unusual tumor. There are approximately 45 cases reported in the literature; the authors report four more cases. This tumor may be associated with other paragangliomas of the head and neck, such as carotid body tumors, and may metastasize to regional lymph nodes, although the histology always appears benign.     

Myxomas of the head and neck

PURPOSE: Myxomas are rare, locally infiltrative, benign, connective tissue tumors that are found in bone and somatic soft tissues. This article reports our experience with head and neck myxomas and provides a comprehensive literature review. MATERIALS AND METHODS: Retrospective record review of head and neck myxoma cases seen at 2 tertiary referral centers in Houston, Texas, from 1970 to 1994. Comprehensive literature review and compilation of all myxomas reported in the head and neck. RESULTS: We identified 7 cases of true head and neck myxoma treated in our centers and identified 169 cases reported in the literature. Most often, myxomas originated in bone (mandible or maxilla) and were most commonly found in adults. All tumors except 1 were treated surgically. Recurrence rates were 6% for local or wide excision and 28% for more conservative surgery such as enucleation or curretage. CONCLUSIONS: Myxomas of the head and neck should be treated with complete excision of the tumor with clear margins.     

Primary carcinoid tumor of the middle ear: a potentially metastasizing tumor

The concept of a carcinoid tumor in the gastrointestinal tract and lung is well established; less often, patients develop carcinoid tumors in the head and neck region. One particularly uncommon site of origin of carcinoid tumors in the head and neck area is the middle ear. Middle ear carcinoids have previously been approached as benign entities, lacking any capacity for metastasizing. A critical review of the literature, however, disclosed a small number of cases in which middle ear carcinoid tumors have given rise to regional (cervical node) metastases. This in turn suggests that, as is the case with pulmonary carcinoid tumors, middle ear carcinoids should be thought of as low-grade malignancies which, while relatively slow-growing, nevertheless possess a limited capacity for spreading to regional lymph nodes. To date, distant metastases have not been associated with middle ear carcinoid tumors.     

Intramuscular hemangiomas of the mylohyoid and sternocleidomastoid muscle

Intramuscular hemangiomas of the head and neck are uncommon benign vascular tumors. They arise frequently in the masseter and trapezius muscle. However, intramuscular hemangiomas arising from the mylohyoid and sternocleidomastoid muscle are extremely rare. We, herein, report additional two cases with intramuscular hemangioma of the mylohyoid and sternocleidomastoid muscle, and review the literatures pertaining to this condition. Imaging studies such as magnetic resonance image (MRI) were diagnostic and the tumors were resected completely with the cuff of normal surrounding muscle. At follow-up examination the patients have been well, without evidence of tumor recurrence after surgery. Intramuscular hemangioma of the head and neck, despite its rarity, should be considered in the differential diagnosis of the head and neck masses.     

Differential diagnosis of cervical space occupying lesion: the parapharyngeal rhabdomyoma]

A case of a parapharyngeal rhabdomyoma is presented. Only about 30 cases of this benign tumor of striated muscles are reported in the literature. Most tumors were located in the lateral cervical region. Histologically a rhabdomyoma must be distinguished from other mesenchymal tumors, especially from granular cell myoblastoma, hibernoma and reticulohistiocytoma. The value of magnetic resonance imaging in the radiological evaluation of parapharyngeal masses is emphasized. Operative resection is generally regarded as the therapy of choice. Local recurrences have been reported in some cases; malignant degeneration is not known.     

Diagnostic dilemmas in soft tissue tumors of the head and neck.

Classifying soft tissue tumors of the head and neck is often difficult for both surgeon and pathologist because of the potential similarities in appearance of metastatic lesions, epithelial tumors, lymphomas, and inflammatory processes. This paper discusses four unusual soft tissue tumors of the head and neck: osteosarcoma of the mandible, biphasic synovial cell sarcoma of the hypopharynx, soft part sarcoma of the maxillary sinus/alveolus, and adult rhabdomyoma of the larynx. Precise diagnosis of these lesions requires adequate tissue sampling, immunocytochemical staining, and electron microscopy. The clinical and pathological features of these tumors, as well as a practical approach to the diagnosis, is presented.