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Adult High-Grade Head and Neck Cutaneous Rhabdomyosarcoma Misdiagnosed as Low-Grade Atypical Fibroxanthoma on Initial Pathology: A Case Report and Review of Diagnostic Considerations
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  • Jake Sims,
  • Claire Walters,
  • Ashbita Pokharel,
  • Shant Korkigian
Jake Sims
Beaumont Hospitals

Corresponding Author:[email protected]

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Claire Walters
Beaumont Hospitals
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Ashbita Pokharel
Beaumont Health System
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Shant Korkigian
Beaumont Health System
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Background: Adult head and neck rhabdomyosarcoma (AHNRMS) is an exceedingly rare soft-tissue sarcoma. We describe a case of AHNRMS that was initially misdiagnosed as atypical fibroxanthoma (AFX). Methods: A 61-year-old male with a history of cutaneous squamous cell carcinoma (cSCC) of left face status post definitive radiation presented with a history of rapidly enlarging masses on the left face and nose. Patient had three large, exophytic masses on the left midface with limited local invasion. Initial pathologic evaluation revealed atypical fibroxanthoma (AFX). Results: Final histopathological and immunohistochemical evaluation after surgical resection of the specimen revealed high-grade cutaneous rhabdomyosarcoma. Patient underwent adjuvant chemoradiation therapy. Conclusions: Soft-tissue sarcomas have considerable overlap in histopathologic presentation, and our case highlights the importance of a thorough immunohistochemical evaluation. This case contributes to the current limited body of literature on cutaneous AHNRMS as well as radiation-associated sarcomas of the head and neck (RASHN).
13 Oct 2022Submitted to Cancer Reports
17 Oct 2022Submission Checks Completed
17 Oct 2022Assigned to Editor
17 Oct 2022Review(s) Completed, Editorial Evaluation Pending
04 Nov 2022Reviewer(s) Assigned
17 Nov 2022Editorial Decision: Revise Minor
23 Nov 20221st Revision Received
25 Nov 2022Submission Checks Completed
25 Nov 2022Assigned to Editor
25 Nov 2022Review(s) Completed, Editorial Evaluation Pending
28 Nov 2022Reviewer(s) Assigned
04 Jan 2023Editorial Decision: Revise Minor