Beghdad M, Mkhatri A, Berrada O, Abada R, Mahtar M
Faculty of Medecine of Casablanca, Department of Otolaryngology, Morocco.
Faculty of Medecine of Casablanca, Department of Otolaryngology, Morocco.
Int J Surg Case Rep. 2020;75:108-111. doi: 10.1016/j.ijscr.2020.08.060. Epub 2020 Sep 3.
Rhabdomyosarcoma is the most common malignant soft tissue tumor in the pediatric age, especially in the head and neck region; in the orbit and the nasopharynx. The middle ear is a very rare site for this neoplasm as it accounts for only 10 % of head neck rhabdomyosarcoma.
We report here the case of a three years-old child who was admitted to the emergency room for a left parotid and retro-auricular swelling with grade V facial palsy. The patient experienced chronic otorrhea with left facial palsy for two months. Two weeks later, a left parotid swelling appeared and gradually increased in size with weight loss. Computed tomography showed a slightly dense tissue lesion in the left mastoid. The patient underwent a diagnostic mastoidectomy. Pathology and immunohistochemical study were compatible with an embryonic rhabdomyosarcoma.
Rhabdomyosarcoma should be considered as a differential diagnosis of any mastoiditis resistant to treatment in a young child. Because of its serious prognosis, rhabdomyosarcoma must be diagnosed at an early stage to increase chances of recovery.
横纹肌肉瘤是儿童期最常见的恶性软组织肿瘤,尤其好发于头颈部区域,如眼眶和鼻咽部。中耳是该肿瘤极为罕见的发病部位,仅占头颈部横纹肌肉瘤的10%。
我们在此报告一例3岁儿童,因左侧腮腺及耳后肿胀伴Ⅴ级面神经麻痹入住急诊室。患者有两个月的左耳慢性耳漏伴面神经麻痹病史。两周后,左侧腮腺出现肿胀,且逐渐增大,伴有体重减轻。计算机断层扫描显示左侧乳突有一稍高密度的组织病变。患者接受了诊断性乳突切除术。病理及免疫组化研究结果符合胚胎型横纹肌肉瘤。
对于任何治疗无效的幼儿乳突炎,应考虑横纹肌肉瘤作为鉴别诊断。由于其预后严重,横纹肌肉瘤必须早期诊断以提高康复几率。