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Clinical Note |

Multiple Adult Rhabdomyomas of the Oropharynx, Base of the Tongue, and Floor of the Mouth Magnetic Resonance Findings

T. Thomas Zacharia, MD; Peter M. Som, MD
Arch Otolaryngol Head Neck Surg. 2008;134(8):892-894. doi:10.1001/archotol.134.8.892.
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Adult rhabdomyomas of the head and neck are uncommon, benign neoplasms that usually present as asymptomatic solitary lesions in the oral cavity, pharynx, or larynx. Rarely do rhabdomyomas occur in multiple sites. We describe the magnetic resonance (MR) imaging appearance of multiple adult rhabdomyomas synchronously involving the floor of the mouth, base of the tongue, and oropharynx in a 70-year-old man.

Rhabdomyomas are rare, benign lesions that account for only 2% of all primary skeletal muscle neoplasms.1 They usually involve the myocardium and, based on histology, are divided into fetal and adult forms. Ninety percent of extracardiac tumors occur in the head and neck.1 Whether all rhabdomyomas are true neoplasms or hamartomas is not clear, but some studies have suggested that the adult form is a true neoplasm. Approximately 3% to 10% of adult rhabdomyomas may be multiple and either synchronous or metachronous. By comparison, fetal rhabdomyomas are almost always solitary lesions. To our knowledge, this is the first MR imaging description of a case of adult rhabdomyomas synchronously involving 3 separate locations in the head and neck.

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Figure 1.

Axial T1-weighted magnetic resonance (MR) image shows an ovoid, well-defined mass with intermediate signal intensity just lateral to the constrictor muscles of the oropharynx, lying within the parapharyngeal space (arrow).

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Figure 2.

Axial T1-weighted magnetic resonance (MR) image shows a discrete mass (arrow) in the left base of the tongue with intermediate signal intensity.

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Figure 3.

Axial T2-weighted magnetic resonance (MR) image shows the parapharyngeal space mass to have low signal intensity.

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Figure 4.

Axial T1 postcontrast fat-saturated magnetic resonance (MR) image shows an enhancing mass in the right floor of the mouth adjacent to the sublingual gland. A parapharyngeal space mass is also seen on the left side.

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