Embryonal Rhabdomyosarcoma of the Nasal Cavity in an Adult : A Case Report

Rhabdomyosarcoma is the most common soft-tissue sarcoma that is most typically found in children under 15 years of age (1). The World Health Organization distinguishes predominantly pleomorphic, alveolar, embryonal and mixed types of rhabdomyosarcoma (2). Head and neck rhabdomyosarcoma is common in childhood, however, is very rare in adults, especially of the embryonal type in the nasal cavity (2, 3). Soft tissue sarcoma makes up less than 1% of all adult malignancies, and rhabdomyosarcoma accounts for 3% of all soft tissue sarcomas (4). Sultan et al. (5) reported that only 9.3% of all adult rhabdomyosarcomas occurred in the head and neck region. A case of rhabdomyosarcoma of the embryonal type located in the nasal cavity of a 24-year-old male is presented and the literature on CT and MR appearance is reviewed. Case A 24-year-old man presented with left nasal obstruction, ipsilateral eye and cheek pain and multiple neck nodules for two months. Clinical examination revealed a mass in the left nasal cavity. Computed tomography (CT) and magnetic resonance imaging (MRI) of the nasal cavity and paranasal sinuses were performed. CT scan with a bone window setting showed a poorly defined, relatively isodense with adjacent muscle, heterogeneous mass of the left nasal cavity that destroyed adjacent bony structures and extended to the surrounding spaces, such as ipsilateral ethmoidal sinus, orbit, nasopharynx, maxillary sinus, sphenoidal sinus, foramen lacerum, cavernous sinus and sphenopalatine foramen. After intravenous administration of contrast material, the mass enhanced to the same degree as adjacent muscles (Fig. 1). MR imaging showed isointense signal in-