Main theme: Head and Neck
Background: Rhabdomyosarcomas (RMS) are the most common sarcoma subtype found in the paediatric population; most commonly occurring within the head and neck region. They account for approximately 5% of paediatric malignancies and are found most often in children under five. Prognosis is dependent on the subtype, with embryonal RMS being the most prevalent.
Methods & Results: We present a case series of three head and neck paediatric rhabdomyosarcoma patients. The first patient, a five-year-old male, presented with a firm swelling over the right lateral nose and an associated erythematous region of the alar crease after a nasal bone injury. Subsequent histology confirmed an alveolar rhabdomyosarcoma. The second patient, a five-year-old male, presented with a facial nerve palsy and otalgia. Subsequent examination showed a mass in the external auditory canal. Further imaging and biopsy confirmed embryonal RMS. The final patient, a fifteen-year-old female, presented with a six-month history of a left pinna lesion, with no history of associated trauma. Initial fine needle aspiration showed evidence of degenerate multinucleate cartilage cells, without evidence of malignancy. An ensuing incisional biopsy confirmed embryonal RMS.
Conclusion: ENT surgeons should remain vigilant for atypical presentations of paediatric rhabdomyosarcomas.
Keywords: rhabdomyosarcoma, facial palsy, nasal bone injury