Multiple synchronous rhabdomyomas in the tongue and floor of the mouth: case report

Abstract

Observation: A 61-year-old male patient presented with tongue and base floor of the mouth firm swelling with intact overlying mucosa with ballottement by bimanual palpation. Histopathological examination and immunodiagnosis revealed this mass as adult rhabdomyoma. Comments: Any tongue base or floor of the mouth mass with intact overlying mucosa should be approached by magnetic resonance imaging with great concern of rhabdomyoma.

Rhabdomyoma of the tongue base

“…Rhabdomyomas in the head and neck are rare tumors and have been reported at variable locations like the lip, tongue, tongue base, soft palate, cheek, orbita, nasopharynx, larynx, the parapharyngeal and paratracheal space, hypopharynx or even multifocal. 2,[4][5][6][7][8][9][10][11] Extracardiac rhabdomyoma cannot be diagnosed by clinical examination only. Histopathological examination is necessary to secure the diagnosis and to exclude differential diagnoses like granular cell tumor, hibernoma, oncocytoma, paraganglioma, histiocytosis and of course rhabdomyosarcoma.…”

“…1 Tissue for histopathological analysis can be collected by direct or needle biopsy/cytology. 4,10 Before deciding on the definitive treatment, the extent of the rhabdomyoma should be determined by proper imaging methods like sonography, MRI or CT. 6 For rhabdomyoma of the head and neck a surgical approach is most common. 2,8 Complete resection is required to prevent recurrence.…”

“…2,8 Complete resection is required to prevent recurrence. 6 Remarkable tumor regression has been observed in cardiac rhabdomyomas with off label use of everolimus and sirolimus, inhibitors of the mTOR pathway, in context of tuberous sclerosis. This offers treatment options for non-operable rhabdomyomas.…”

“…1 Furthermore multifocal extracardiac rhabdomyomas are documented too, but are extremely rare. 2,4,6 The affection of the tongue base has been rarely described. 6,7…”