Abstract
Rhabdomyomas of the head and neck are exceptionally rare benign mesenchymal tumors. Although histology is very characteristic, several differential diagnoses have to be considered. We investigated five patients with extracardiac rhabdomyoma of the head and neck (median age 65.9 years), four of them presenting with adult rhabdomyoma (AR) and one with fetal rhabdomyoma (FR). We analyzed the histological findings, with special regard to separation from hibernoma (two patients) and granular cell tumor (GCT; six patients, median age 31 years). Both FR and AR showed polygonal eosinophilic cells with peripherally or centrally localized nuclei and cross striations, while in hibernoma, multivacuolated cells with centrally localized nuclei were detected. In GCT, polygonal eosinophilic cells with granular periodic-acid-Schiff-positive cytoplasm were found; in one case, atypical GCT with increased pleomorphism and mitotic rate was observed. Pseudoepitheliomatous hyperplasia occurred both in FR and GCT. Immunohistochemically, rhabdomyomas were strongly positive for myogenic markers (desmin, actin, and myoglobin) but negative for S-100, while hibernoma and GCT strongly expressed S-100. Concerning the differential diagnosis of rhabdomyoma, GCT has to be especially considered since this tumor can undergo malignant transformation.
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References
Abrikossoff A (1926) Über Myome, ausgehend von der quergestreiften willkürlichen Muskulatur. Virchows Arch 260:215
Brandwein M, LeBenger J, Strauchen J, Biller H (1990) Atypical granular cell tumor of the larynx: an unusually aggressive tumor clinically and microscopically. Head Neck 12:154–159
Fanburg-Smith JC, Meis-Kindblom JM, Fante R, Kindblom LG (1998) Malignant granular cell tumor of soft tissue: diagnostic criteria and clinicopathologic correlation. Am J Surg Pathol 22:779–794
Favia G, Lo Muzio L, Serpico R, Maiorano E (2003) Rhabdomyoma of the head and neck: clinicopathologic features of two cases. Head Neck 25:700–704
Filie AC, Lage JM, Azumi N (1996) Immunoreactivity of S100 protein, alpha-1-antitrypsin, and CD68 in adult and congenital granular cell tumors. Mod Pathol 9:888–892
Fletcher DM, Unni K, Mertens F (eds) (2002) World Health Organization classification of tumours. Tumours of soft tissue and bone. IARC, Lyon
Furlong MA, Fanburg-Smith JC, Miettinen M (2001) The morphologic spectrum of hibernoma. A clinicopathologic study of 170 cases. Am J Surg Pathol 25:809–814
Gibas Z, Miettinen M (1992) Recurrent parapharyngeal rhabdomyoma. Evidence of neoplastic nature of the tumor from cytogenetic study. Am J Surg Pathol 16:721–728
Hansen T, Burg JE, Koutsimpelas D, Mann WJ, Kirkpatrick CJ (2005) Cervical adult rhabdomyoma presenting as a rapidly growing mass in a patient with diffuse large B-cell non-Hodgkin lymphoma. Mund Kiefer Gesichtschir 9:184–187
Kapadia SB, Meis JM, Frisman DM, Ellis GL, Heffner DK, Hyams VJ (1993) Adult rhabdomyoma of the head and neck: a clinicopathologic and immunophenotypic study. Human Pathol 24:608–617
Katenkamp K, Katenkamp D (2005) Low-malignant peripheral nerve sheath tumors of nasal and sinonasal mucous membranes. Pathologe 26:90–95
Lee MW, Chang SE, Song KY, Choi JH, Sung KJ, Moon KC, Koh JK (2002) S-100-negative atypical granular cell tumor: report of a case. Int J Dermatol 41:168–170
Miettinen M (ed) (2003) Diagnostic soft tissue pathology. Churchill Livingstone, Philadelphia
Nolte E, Kleinsasser O (1982) Granular cell tumors of the larynx. HNO 30:333–339
Scrivner D, Meyer JS (1980) Multifocal recurrent adult rhabdomyoma. Cancer 46:790–795
Stewart CM, Watson RE, Eversole LR, Fischlschweiger W, Leider AS (1988) Oral granular cell tumors: a clinicopathologic and immunocytochemical study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 65:427–435
Tardio JC, Aramburu JA, Santonja C (2004) Desmin expression in spindle cell lipomas: a potential diagnostic pitfall. Virchows Arch 445:354–358
Vermeersch H, van Vugt P, Lemmerling M, Moerman M, De Potter (2000) Bilateral recurrent adult rhabdomyomas of the pharyngeal wall. Eur Arch Otorhinolaryngol 257:24–26
Weiss SW, Goldblum JR (eds) (2001) Soft tissue tumors, 4th edn. Mosby, St. Louis, pp 769–783
Welzel C, Gajda M, Jamali Y, Schrom T, Berghaus A, Holzhausen HJ (2001) Adult multilocular rhabdomyoma as a cause of a space-occupying lesion in the neck region. HNO 49:553–556
Willis J, Abdul-Karim FW, di Sant'Agnese PA (1994) Extracardiac rhabdomyomas. Semin Diagn Pathol 11:15–25
Acknowledgements
We wish to thank the following colleagues for kindly providing of the cases: Dr. Boenigk (Remscheid, Germany), Prof. Bültmann (Tübingen, Germany), Dr. Hallermann (Münster, Germany), Prof. Kriegsmann (Trier, Germany), Dr. Markmann (Stuttgart, Germany), Dr. May (Berlin, Germany), Dr. Peters (Lüneburg, Germany), Dr. Rotter (Straubing, Germany), Dr. Schütze (Suhl, Germany), Dr. Sonntag (Ravensburg, Germany), and Dr. Tchiba (Hilden, Germany).
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Hansen, T., Katenkamp, D. Rhabdomyoma of the head and neck: morphology and differential diagnosis. Virchows Arch 447, 849–854 (2005). https://doi.org/10.1007/s00428-005-0038-8
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DOI: https://doi.org/10.1007/s00428-005-0038-8