Solid variant of alveolar rhabdomyosarcoma in the head and neck region: a case report of a diagnostic dilemma in a head and neck fine needle aspiration clinic

Alveolar rhabdomyosarcoma (ARMS) is one of the major categories of rhabdomyosarcomas; it encompasses malignant tumors of striated muscle and occurs more frequently in the extremities. It is uncommonly reported in young adults and extremely rarely found in middle-aged and elderly patients.A 54-year-old man presented to a rapid head and neck clinic with a history of rapid enlargement of neck lumps on the right side of his neck over a period of 5 weeks. The diagnosis of an undifferentiated malignant small round cell tumor was made from cytologic examination of the aspirated sample, and biopsy of the lesion was advised. On histologic analysis, diagnosis of solid variant of ARMS was made.A solid variant of ARMS in an older population has not been published in the literature within the settings of a rapid head and neck clinic. Therefore, the remote possibility of this diagnosis should be considered in the differential diagnosis of a malignant, round cell tumor in fine needle aspiration cytology in an older patient's neck lump.