Misdiagnosis of a chin abscess in a teenager with rhabdomyosarcoma – consequences for the patient’s health and quality of life

Childhood rhabdomyosarcoma (RMS) develops frequently within head and neck (H&N) structures. Its clinical manifestation may mimic more common benign, inflammatory, and congenital lesions.

A 16-year-old boy with painless purple swelling of the chin soft tissues was treated with local and systemic antibiotics. Because no improvement was achieved, the growing “abscess” was incised and drained many times in the surgical department. After three months of ineffective therapies, the patient was transferred to the clinical hospital, where a tumour infiltrating the chin and oral cavity floor, impairing speech and swallowing, was detected. Alveolar RMS was diagnosed by histopathology of the tumour biopsy. Due to unfavourable prognostic factors, the patient was classified to a very high-risk group and received aggressive long-lasting oncological treatment. Although he achieved full remission, the sequelae of therapy affect his quality of life.

Despite its rarity, RMS should be included in the differential diagnosis of H&N lesions, especially painless and rapidly growing.