Embryonal Rhabdomyosarcoma (Botryoid Subtype) Affecting the Buccal Mucosa

Area of Science:

• Oral pathology
• Pediatric oncology
• Soft tissue tumors

Background:

• Rhabdomyosarcoma (RMS) is a rare malignant soft tissue tumor.
• Oral RMS is uncommon, with varied pathological features influencing prognosis.
• Early diagnosis and appropriate treatment are crucial for managing RMS.

Observation:

• A 13-year-old female presented with a 3-month history of an asymptomatic 2.5 cm polypoid buccal mucosal swelling.
• Initial presumptive diagnosis was fibrous hyperplasia; excisional biopsy was performed.
• Histopathology revealed a papillary-verrucous lesion with ovoid cells in a subepithelial cambium layer.

Findings:

• Immunohistochemistry showed strong positivity for desmin, myogenin, and Ki-67.
• The tumor was diagnosed as embryonal rhabdomyosarcoma, botryoid variant.
• The patient received chemotherapy and radiotherapy.

Implications:

• This case highlights the importance of considering rare tumors in differential diagnoses.
• Accurate histopathological and immunohistochemical analysis is key for diagnosing oral RMS.
• Multimodal treatment including chemotherapy and radiotherapy led to a positive outcome with no recurrence at 12 months.