Parotid rhabdomyosarcoma with spindle cell features masquerading as a benign salivary gland tumour: Pitfall alert

Rhabdomyosarcoma (RMS) is the most common sarcoma in children and adolescents, with the head and neck region, extremities, and genitourinary tract being the most common locations. Rhabdomyosarcoma of the salivary glands is rarely seen in children and can easily be mistaken for their benign counterparts. We report a case of rhabdomyosarcoma in the parotid region that clinically and cytologically masqueraded as a benign parotid gland tumour, leading to diagnostic difficulties. However, the excised specimen revealed histomorphological and immunophenotypic features consistent with rhabdomyosarcoma. The child underwent a total parotidectomy followed by chemotherapy and is doing well without recurrence. Although cytology is minimally invasive and has good specificity, there are rare cases, such as this one, where histopathology provided the definitive diagnosis. This report aims to raise awareness of RMS of the parotid gland among clinicians, cytopathologists, and radiologists, aiding in the early diagnosis and treatment of these cases.