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Facial Pain as the Initial Presentation of Rhabdomyosarcoma: A Case Report
Najmeh Anbiaee1, Atessa Pakfetrat2, Shayan Yousefi3
1Department of Oral and Maxillofacial Radiology, Faculty of Dentistry Mashhad University of Medical Sciences (MUMS) Mashhad Iran.
Abstract:
Spindle cell/sclerosing rhabdomyosarcoma (RMS) is an uncommon and aggressive neoplasm, especially in adults. This case details a 35-year-old male with a 4-year history of persistent idiopathic facial pain (PIFP), first misdiagnosed owing to the lack of definitive clinical or radiologic evidence. Advanced imaging ultimately identified a malignant tumor in the infratemporal fossa, which was confirmed as rhabdomyosarcoma through histological examination. Owing to the tumor's inaccessibility, surgical removal was unfeasible, and despite chemotherapy, the cancer advanced, resulting in the patient's death. This example highlights the significance of prompt advanced imaging and interdisciplinary cooperation in detecting uncommon cancers that manifest as persistent pain. Given the diagnostic challenge, this case underscores the critical need to consider rhabdomyosarcoma in the differential diagnosis of persistent head and neck pain, especially when conventional evaluations fail to determine a cause. Early recognition and comprehensive diagnostic approaches can improve patient outcomes.
Insights
Rhabdomyosarcoma, a rare cancer, can present as persistent facial pain, delaying diagnosis. Early advanced imaging and multidisciplinary care are crucial for identifying such aggressive neoplasms.
Area of Science:
- Oncology
- Pathology
- Radiology
Background:
- Spindle cell/sclerosing rhabdomyosarcoma (RMS) is a rare and aggressive tumor, particularly in adults.
- Persistent idiopathic facial pain (PIFP) can mask underlying malignancies, leading to diagnostic delays.
Purpose of the Study:
- To highlight a challenging case of adult rhabdomyosarcoma presenting as persistent facial pain.
- To emphasize the importance of advanced imaging and interdisciplinary collaboration in diagnosing rare cancers.
Main Methods:
- Case report of a 35-year-old male with a 4-year history of PIFP.
- Utilized advanced imaging to identify an infratemporal fossa tumor.
- Histological examination confirmed rhabdomyosarcoma.
Main Results:
- The tumor was ultimately diagnosed as rhabdomyosarcoma after initial misdiagnosis.
- The tumor's location rendered surgical removal unfeasible.
- Despite chemotherapy, the patient's condition progressed, leading to a fatal outcome.
Conclusions:
- Rhabdomyosarcoma should be considered in the differential diagnosis of persistent head and neck pain, especially when conventional methods fail.
- Prompt advanced imaging and a multidisciplinary approach are vital for early detection and improved outcomes in uncommon cancer presentations.
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