Embryonal Rhabdomyosarcoma - A Mimicker of Squamosal Otitis Media

Document Type : Case Report


1 Department of Otorhinolaryngology, Kasturba Medical College, Manipal Academy of Higher Education Madhavnagar Manipal - 576104.

2 Department of Pathology, Kasturba Medical College, Manipal Academy of Higher Education Manipal.


Rhabdomyosarcoma is the most frequently occurring intrusive soft tissue sarcoma in the pediatric age group. Orbit is the most common location for a pediatric rhabdomyosarcoma, but it can occur in the oral cavity, pharynx, face and neck in the descending order of incidence. Rhabdomyosarcoma in the ear is extremely rare.
Case Report:
A 5-year-old girl presented to the outpatient department of our tertiary care hospital with complaints of foul smelling, non-blood stained right ear discharge of one-month duration and deviation of angle of mouth to the left side of acute onset. Investigations revealed a diagnosis of embryonal rhabdomyosarcoma. Multimodal therapy was carried out, and the child was rendered disease-free after two years.
Embryonal rhabdomyosarcoma of the head and neck mimics chronic otitis media. Early diagnosis is essential to deliver prompt treatment and prevent locoregional spread and metastasis.


  1. Eksan MS, Noorizan Y, Chew YK, Noorafidah MD, Asma A. Rare embryonal rhabdomyosarcoma of external acoustic canal: a case report and literature review. Am J Otolaryngol. 2014 Nov-Dec; 35(6): 814-5.
  2. Vegari S, Hemati A, Baybordi H, Davarimajd L, Chatrbahr G. Embryonal rhabdomyosarcoma in mastoid and middle ear in a 3-year-old girl: a rare case report. Case Rep Otolaryngol. 2012; 2012:871235.doi:10.1155/2012/ 871235. Epub2012Jun18.
  3. Muranjan M, Karande S, Parikh S, Sankhe S. A mistaken identity: rhabdomyosarcoma of the middle ear cleft misdiagnosed as chronic suppurative otitis media with temporal lobe abscess. BMJ Case Rep. 2014 Sep 19; 2014. pii: bcr 2014206615. doi: 10.1136/bcr-2014-206615.
  4. Crozier E, Rihani J, Koral K, Cope-Yokoyama S, Rakheja D, Ulualp SO. Embryonal rhabdomyosarcoma of the auricle in a child. Pediatr Int. 2012 Dec; 54(6):945-7.
  5. Vasiwala R, Burud I, Lum SK, Saren RS. Embryonal rhabdomyosarcoma of the middle ear presenting with aural polyp and facial nerve palsy. Med J Malaysia. 2015 Oct;70(5):314-5.
  6. Bhargava S, Grover M, Mehta J, Maheshwari V. Rhabdomyosarcoma in middle ear of an adult: a rare presentation. J Surg Case Rep. 2012 Oct 1; 2012(10):9.
  7. Hu J, Liu S, Qiu J. Embryonal rhabdomyosarcoma of the middle ear. Otolaryngol Head Neck Surg. 2002 Jun; 126(6):690-2.
  8. Durve DV, Kanegaonkar RG, Albert D, Levitt G. Paediatric rhabdomyosarcoma of the ear and temporal bone. Clin Otolaryngol Allied Sci. 2004 Feb; 29(1):32-7.
  9. Sbeity S, Abella A, Arcand P, Quintal MC, Saliba I. Temporal bone rhabdomyosarcoma in children. Int J Pediatr Otorhinolaryngol. 2007; 71: 807-14.
  10. King MT, Voros L, Cohen GN, Lanning RM, Ganly I, O'Suoji CC, et al. High-dose-rate brachytherapy of rhabdomyosarcoma limited to the external auditory canal. Brachytherapy. 2017 Jan - Feb; 16(1):181-5.
  11. Janz TA, Camilon PR, Cheung AY, Nguyen SA, White DR, Weber PC. A review of pediatric middle ear tumors and analysis of the demographics, management, and survival of pediatric rhabdomyosarcomas of the middle ear. Int J Pediatr Otorhinolaryngol. 2018 Sep;112:109-12.