Pharyngeal rhabdomyoma: an unusual presentation

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Abstract
A case of pharyngeal rhabdomyoma is reported with the unusual presenting symptom of hemoptysis. After complete excision of the lesion, the 71 yr old patient remained tumor-free until his death from heart disease 19 mo. later. Published cases of pharyngeal rhabdomyoma (7) are reviewed with 27 other reported extracardiac adult rhabdomyomas which, with a single exception, occurred in the head and neck region. Adult extracardiac rhabdomyomas are benign tumors arising from skeletal muscle. It is virtually impossible to determine the true incidence of these extremely rare neoplasms as they were confused in the past with granular cell myoblastomas, rhabdomyosarcomas and hamartomas and, more recently, with fetal rhabdomyomas. At least 27 acceptable examples were published. All but 1 of the recorded adult extracardiac rhabdomyomas developed from sites in the head and neck; the single exception occurred in the stomach. Other reviewers cited a higher incidence of rhabdomyomas occurring outside the head and neck, but these probably include fetal rather than the adult type of lesion. Adult rhabdomyomas were encountered at several sites within the head and neck: 7 in the larynx, 6 in the submandibular/sublingual/floor of mouth region, 7 in the Pharynx, 4 in the cervical musculature and single examples in the tongue, orbit and lip. The ages of the patients at the time of presentation ranged from 8-82 yr with a mean age of 54 yr. There was a male preponderance of almost 6:1. Most of the tumors were discrete though 4 were multifocal. In 3 patients with diagnosis was made at autopsy. The tumors ''recurred'' in 4 instances, apparently due to incomplete excision. The presenting symptoms of the rhabdomyomas previously described were due to local swelling and/or pressure. The example reported here is unique in that the patient presented with hemoptysis.

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