Nasal ala rhabdomyosarcoma misdiagnosed as a facial infection

Summary 

We present the case of an 18-month-old female with nasal ala swelling thought to be of infectious etiology. There was no response to multiple courses of oral and topical antibiotics. Biopsy of the lesion revealed alveolar rhabdomyosarcoma. The patient received the D9803 closed trial chemotherapy protocol for intermediate risk rhabdomyosarcoma standard arm and high-dose-rate brachytherapy. Treatment with a combination of chemotherapy and brachytherapy is becoming increasingly accepted for this type of tumor and is associated with limited morbidity. Although facial rhabdomyosarcoma is relatively uncommon, it should be part of the differential diagnosis in the presence of a rapidly growing facial swelling unresponsive to antibiotics.

Keywords: Rhabdomyosarcoma, Head and neck oncology, Pediatric oncology, Nasal ala, Facial infection, Brachytherapy