Cervical adult rhabdomyoma presenting as a rapidly growing mass in a patient with diffuse large B-cell non-Hodgkin's lymphoma.
BACKGROUND
Adult rhabdomyoma is a rare mesenchymal tumor, which generally grows slowly and is mainly localized in the head and neck area.


METHODS
We report the extraordinary case of a rapidly growing adult rhabdomyoma in a 73-year-old man. The patient was treated for diffuse large B-cell non-Hodgkin's lymphoma with CHOP therapy (doxorubicin, cyclophosphamide, vincristine, and prednisone). Comparison of the respective computed tomography scans showed prominent enlargement of 35% in the tumor mass volume on the right side of the neck within 3 months. The tumor was highly suspicious for lymphoma. Surgical resection was performed.


RESULTS
Histological examination revealed a tumor which was composed of tightly packed polygonal cells with a PAS-positive granular or vacuolated cytoplasm, occasionally with cross-striations. Immunohistochemically, the cells were positive for desmin, myogenin, Myo-D1, but negative for S-100. Due to these characteristic morphologies, adult rhabdomyoma was diagnosed.


CONCLUSIONS
This is the first report on an adult rhabdomyoma with a proven rapid enlargement. The possible pathomechanisms are discussed.
Hansen
T
T
Institute of Pathology, Johannes Gutenberg-University of Mainz. TorstenHansen@gmx.de
Burg
J E
JE
Koutsimpelas
D
D
Mann
W J
WJ
Kirkpatrick
C J
CJ
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000139:chemically induced / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D016393:Lymphoma, B-Cell / Q000139:chemically induced / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000139:chemically induced / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012207:Rhabdomyoma / Q000139:chemically induced / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D040521:Subcutaneous Tissue / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014750:Vincristine / Q000009:adverse effects / Q000627:therapeutic use
D014408:Biomarkers, Tumor; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone