Pleomorphic rhabdomyosarcoma of the tongue in adult mimicking oral squamous cell carcinoma

Abstract

Background: Oral cancer is one of the sixth most common cancers in human, and oral squamous cell carcinoma (OSCC) is the most common type of oral cancer. The clinical appearance of OSCC may resemble other types of oral cancer such as rhabdomyosarcoma (RMS). The definitive diagnosis is crucial as the management and prognosis of both lesions are quite different. Case Report: A 42-year-old male presented with a unhealed painful ulcer of the posterior right lateral border of the tongue for about 4 months. Restricted mobility of the tongue and positive submandibular lymph nodes were detected. Wide excision with regional neck dissection was performed. Discussion: Pleomorphic RMS (PRMS) was identifed by immunohistochemistry of positive desmin and smooth muscle actin. The clinical presentation of the lesion is exactly similar to OSCC. PRMS is a rare type of high-grade sarcoma of the oral cavity. It usually occurs in the deep of lower extremities of adult on the six decade. Conclusion: Although the management of OSCC and RMS is almost alike, the ability of metastasis is salient compared to OSCC. Therefore, the definitive diagnosis should be careful due to its characteristic.