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Pediatric Patient with Rhabdomyosarcoma Involving Temporal Bone: Case Report and Overview of Recent Cases
Khalid Suwayyid Alomar1, Rafeef Alhajress1, Abdullah Saleh Alsheikh1
1Department of Otolaryngology, King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Insights
Rhabdomyosarcoma, a rare pediatric cancer, can present as a persistent ear infection. Early diagnosis and treatment are crucial for improving outcomes in children with this aggressive soft-tissue sarcoma.
Area of Science:
- Pediatric oncology
- Otolaryngology
- Pathology
Background:
- Middle ear tumors are rare in children.
- Rhabdomyosarcoma is the most common pediatric soft-tissue sarcoma, originating from embryonic mesenchymal cells.
- It is an aggressive malignancy with metastatic potential.
Observation:
- A 2-year-old boy presented with chronic ear pain and bleeding, initially misdiagnosed as an ear infection.
- Lack of clinical improvement prompted further investigation with radiological imaging.
- Diagnosis of embryonal rhabdomyosarcoma of the temporal bone was confirmed after extensive workup.
Findings:
- This case highlights a rare presentation of embryonal rhabdomyosarcoma in a pediatric patient.
- Delayed diagnosis of rhabdomyosarcoma can significantly increase fatality rates in children.
- The tumor's aggressive nature necessitates a high index of suspicion for early detection.
Implications:
- Emphasizes the importance of considering rare diagnoses like rhabdomyosarcoma in pediatric ear infections unresponsive to treatment.
- Highlights the critical role of early detection and multimodal therapy in improving survival rates for pediatric rhabdomyosarcoma.
- Underscores the need for increased physician awareness regarding the diverse presentations of pediatric malignancies.
Abstract:
BACKGROUND In the pediatric age group, middle ear tumors are rare. Rhabdomyosarcoma is considered the most common soft-tissue sarcoma in children. It comprises 5% of all pediatric malignant tumors. It is hypothesized to originate from embryonic mesenchymal cells of striated skeletal muscles. These malignant lesions display an aggressive behavior with local and distant metastasis and can be staged as per the Intergroup Rhabdomyosarcoma Study Group, depending on the organs involved, such as the orbit, head, neck, or genitourinary tract. CASE REPORT In this study, a 2-year-old boy with no medical ailments was presented with a history of ear pain and on/off bleeding from the right ear for 1 year. The patient's case was initially managed medically, for the clinical picture of an ear infection. However, clinical improvement was not seen. Therefore, radiological imaging was done. After further investigations, the diagnosis was confirmed, and a rare case of embryonal rhabdomyosarcoma of the temporal bone was reported. CONCLUSIONS Rhabdomyosarcoma is an uncommon tumor in which delayed diagnosis could cause a significant fatality rate in children. Physicians need a strong index of suspicion to make an early diagnosis. The presented case is of a 2-year-old boy with a clinical picture of a complicated ear infection who was found to have rhabdomyosarcoma of the temporal bone. Early detection and multimodal treatment are critical for a positive outcome.
