Rhabdomyoma of larynx - A diagnaostic dilemma

Introduction: Rhabdomyomas of the head and neck are unusual. Extracardiac rhabdomyoma is a rare benign tumor of striated muscle origin that is found in adults and children. We report a case of rhabdomyoma of the larynx, which presented a diagnostic dilemma. Case report: We report an uncommon case of a 50-year-old man, who presented with change in voice for two years. Endoscopic examination of the larynx revealed a smooth mass covered by intact mucosa involving the right aryepiglottic fold and a false vocal cord with restricted right vocal cord mobility. Biopsy from the lesion revealed a diagnosis of squamous cell carcinoma. The patient underwent total laryngectomy. To our surprise, histologic examination and immunohistochemical diagnosis proved it to be rhabdomyoma of the adult type with no evidence of malignancy. Discussion: Most extracardiac rhabdomyomas arise from the pharyngeal constrictor muscles, the floor of the mouth, or the base of the tongue. Rarely, rhabdomyomas may arise from the larynx. Histologic and immunohistochemical analysis is essential for diagnosis. Treatment of rhabdomyoma consists primarily of complete excision with preservation of the surrounding tissues. Conclusion: Our case demonstrates various differential diagnoses possible in laryngeal neoplasms. It also shows that immunocytochemistry plays an important role in differential diagnosis.