Tongue Rhabdomyosarcoma in Adults: A Case-Based Review

Rhabdomyosarcoma (RMS) of the tongue in adults is an exceptionally rare and aggressive malignancy, often posing significant challenges in diagnosis and management. Due to its rarity, most available data come from isolated case reports and small retrospective studies. It typically presents as a rapidly enlarging tongue mass, leading to symptoms such as dysphagia, speech disturbances, and airway obstruction. Diagnosis relies on imaging studies and histopathological confirmation, with immunohistochemical markers playing a crucial role in differentiation from other malignancies. We present a case of an adult patient who developed a tongue mass with progressive symptoms. Imaging revealed a large tumor at the base of the tongue, and biopsy confirmed a high-grade RMS. Due to worsening clinical symptoms, surgical resection was performed before the final histopathological diagnosis was available. Despite initial treatment, the tumor recurred, requiring a second surgical intervention followed by radiation therapy. At the 12-month follow-up, the patient remained disease-free. A literature review identified 12 previously reported cases of adult tongue RMS, highlighting the variability in treatment approaches, with most patients undergoing surgical resection, often combined with chemotherapy or radiotherapy. Given the high risk of recurrence, a multimodal treatment strategy is necessary to improve survival outcomes. Early diagnosis and regular follow-up are critical as recurrence often necessitates additional surgical interventions. Further studies are needed to better understand the long-term prognosis and optimize treatment strategies for this rare malignancy.