Unique manifestation of a multifocal adult rhabdomyoma invol
A 65-year-old male was referred to our department with a constant urge to clear the throat for a time span of 12 months. In addition, the patient stated his progressing inability to swallow food. Due to these symptoms, a resection of the thyroid gland had been carried out earlier showing struma colloides nodosae as well as bilateral parathyroidal adult rhabdomyomae. Even so, there was no relief in symptoms. At outpatient presentation at his dentist, a slight swelling of the soft palate was felt and the patient was referred for further therapy.

Endoscopic examination as well as magnetic resonance imaging unveiled a tumor on the right side of the soft palate with a size of 5 × 5 cm2 and distinct demarcation to the surrounding tissue. Subsequently, the lesion was completely excised and histopathological analysis was conducted that showed a circumscribed but not encapsulated mesenchymal tumor with polygonal cell formation. The cells presented a granular cross-striated eosinophilic cytoplasm, large round vesicular nuclei and so called spiderweb cells. Immunohistochemically, the cytoplasm of the cells was 100% positive for antibodies to desmin and S100. Additional immunohistochemical markers showed slight nuclear positivity for myogenin and nuclear negativity for AE1/3, CD68 as well as melan A. The histological examination confirmed ARM without signs of malignancy.

At a total follow-up of 3 years, including MRI scan, no signs of recurrence were detected.

Source: Journal of Surgical Case Reports, Volume 2019, Issue 4, April 2019, rjz116

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