{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:26:34Z","timestamp":1787502394635,"version":"build-2736575974"},"update-to":[{"DOI":"10.12688\/f1000research.20558.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2019,11,15]],"date-time":"2019-11-15T00:00:00Z","timestamp":1573776000000}}],"reference-count":9,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2019,11,15]],"date-time":"2019-11-15T00:00:00Z","timestamp":1573776000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>We present a rare case of a four-year-old boy with a botyroid embryonal rhabdomyosarcoma of the right middle ear. Rhabdomyosarcoma is a soft tissue malignancy which is thought to originate from embryonic mesenchymal cells of striated skeletal muscle.\u00a0 It is a disease primarily of children and is exceptionally rare in parameningeal regions.\u00a0 The diagnosis is often delayed and easily misdiagnosed as aural polyp. Therefore, advanced disease is common at the time of diagnosis.\u00a0 A four-year-old boy presented with a four-month history of recurrent left ear blood and pus discharge, otalgia and fevers. He attended his GP three times and paediatric A&amp;E 13 times where he received antibiotics for presumed otitis media and externa. He was eventually referred to the otolaryngology department and underwent an examination under anaesthesia of ear and excisional biopsy of a suspicious aural polyp.\u00a0 Staging chest CT and\u00a0PET scan showed no loco-regional spread or distal metastasis. Magnetic resonance imaging demonstrated absence of invasion into adjacent organs.\u00a0 Histology confirmed embryonal rhabdomyosarcoma, botryoid subtype.\u00a0 Subsequent to the initial excision of the polyp, he was started on an ifosfamine, vincristine and actinomycin (IVA) chemotherapy regime in three weekly cycles for nine cycles with concomitant radiotherapy. Two weeks subsequent to his first chemotherapy dose he presented with a House-Brackmann II-III facial nerve palsy but no other middle ear complications. He was started on intravenous antibiotics and dexamethasone. The facial nerve palsy incompletely resolved with treatment.<\/ns4:p>","DOI":"10.12688\/f1000research.20558.2","type":"journal-article","created":{"date-parts":[[2019,11,15]],"date-time":"2019-11-15T06:55:08Z","timestamp":1573800908000},"page":"1734","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Case Report: Case report: A rare case of middle-ear Rhabdomyosarcoma in a 4-year-old boy"],"prefix":"10.12688","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3449-8594","authenticated-orcid":false,"given":"Richard","family":"Menzies-Wilson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gentle","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prodip","family":"Das","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2019,11,15]]},"reference":[{"key":"ref-1","article-title":"SEER Cancer Statistics Review","author":"L Ries","year":"2003"},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"520-525","DOI":"10.1007\/s12070-011-0434-0","article-title":"Clinical and histopathological study of mass in ear: a study of fifty cases.","volume":"65","author":"N Agarwal","year":"2013","journal-title":"Indian J Otolaryngol Head Neck Surg."},{"key":"ref-3","first-page":"123-126","article-title":"Clinical and radiological findings of the middle ear' embryonal rhabdomyosarcoma and temporal bone in the children.","volume":"14","author":"J Ferraz-filho","year":"2010","journal-title":"Int Arch Otorhinolaryngol."},{"key":"ref-4","first-page":"157-160","article-title":"Rhabdomyosarcoma of the Middle and Inner Ear.","volume":"1","author":"S Shirani","year":"2003","journal-title":"Iran J Radiol."},{"key":"ref-5","first-page":"1846-1902","article-title":"Tumors of the head and neck in children","author":"R Cotton","year":"1999"},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"780-784","DOI":"10.1177\/014556130508401214","article-title":"Rhabdomyosarcoma of the middle ear and mastoid: a case report and review of the literature.","volume":"84","author":"A Akbar","year":"2005","journal-title":"Ear Nose Throat J."},{"key":"ref-7","first-page":"730-733","article-title":"Rhabdomyosarcoma of the middle ear: imaging features in two children.","volume":"14","author":"M Castillo","year":"1993","journal-title":"AJNR Am J Neuroradiol."},{"key":"ref-8","article-title":"Rhabdomyosarcoma in childhood and adolescence: Epidemiology, pathology, and molecular pathogenesis","author":"M Fatih","year":"2017"},{"key":"ref-9","doi-asserted-by":"publisher","first-page":"411-420","DOI":"10.1016\/S1470-2045(05)70208-4","article-title":"Tumours of the external ear and temporal bone.","volume":"6","author":"K Devaney","year":"2005","journal-title":"Lancet Oncol."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/8-1734\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/8-1734\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/8-1734\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,11,15]],"date-time":"2019-11-15T06:55:10Z","timestamp":1573800910000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/8-1734\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,15]]},"references-count":9,"URL":"https:\/\/doi.org\/10.12688\/f1000research.20558.2","relation":{},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,15]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/8-1734\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.22599.r54913, Max Cunnane, Royal Sussex County Hospital, Brighton, UK, 16 Oct 2019, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/8-1734\/v1#referee-response-54913","order":0,"name":"referee-response-54913","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.22599.r54912, Craig Hickson, Leicester Royal Infirmary, Leicester, UK, 31 Oct 2019, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/8-1734\/v1#referee-response-54912","order":1,"name":"referee-response-54912","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Richard Menzies-Wilson<\/b>; \n<i>Posted: 11 Nov 2019<\/i>; Many Thanks for your comments.&nbsp; We have adjusted the manuscript to reflect your feedback.","URL":"https:\/\/f1000research.com\/articles\/8-1734\/v2#referee-comment-5020","order":2,"name":"referee-comment-5020","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.22599.r54909, Adam Haymes, Department of Otolaryngology Surgery, Medway Maritime Hospital, Gillingham, Kent, UK, 05 Nov 2019, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/8-1734\/v1#referee-response-54909","order":3,"name":"referee-response-54909","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}