{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:00:09Z","timestamp":1790312409906,"version":"4.1.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adult-type extracardiac rhabdomyoma is a rare benign skeletal-muscle neoplasm that most often arises in the head and neck but is exceptional in the parapharyngeal space, where it may mimic salivary or neurogenic tumours. Case presentation: A 67-year-old man presented with a 6-month history of progressive dysphagia, globus sensation, and mild hoarseness. Computed tomography and magnetic resonance imaging demonstrated an approximately 9-cm, well-circumscribed right parapharyngeal mass with relatively homogeneous internal characteristics and mild-to-moderate enhancement. Because direct glottic exposure was inadequate, tracheotomy-assisted airway management preceded complete excision through a right lateral transcervical approach. Histopathology showed large polygonal cells with abundant eosinophilic granular cytoplasm. The tumour was positive for desmin and smooth-muscle actin, with focal MyoD1 and myogenin expression, a low Ki-67 labelling index, and negative S-100 staining, supporting adult-type rhabdomyoma. Recovery was uneventful, and magnetic resonance imaging at 6 and 12 months showed no recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adult rhabdomyoma should be considered in the differential diagnosis of a well-circumscribed parapharyngeal mass in an older adult. Integrated radiological and pathological assessment, careful airway planning, complete conservative excision, and long-term surveillance are central to management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1945205","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:27:50Z","timestamp":1790310470000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Giant adult rhabdomyoma of the parapharyngeal space: diagnostic and surgical pitfalls"],"prefix":"10.3389","volume":"13","author":[{"given":"Bingyi","family":"Dai","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Affiliated Hospital of Jiangnan University","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyang","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Affiliated Hospital of Jiangnan University","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Affiliated Hospital of Jiangnan University","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changling","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Affiliated Hospital of Jiangnan University","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Affiliated Hospital of Jiangnan University","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1016\/0046-8177(93)90240-H","article-title":"Adult rhabdomyoma of the head and neck: a clinicopathologic and immunophenotypic study","volume":"24","author":"Kapadia","year":"1993","journal-title":"Hum Pathol"},{"key":"B2","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1002\/1097-0142(19800815)46:4<780::AID-CNCR2820460423>3.0.CO;2-K","article-title":"Extracardiac rhabdomyoma: a clinicopathologic study and review of the literature","volume":"46","author":"Di Sant'Agnese","year":"1980","journal-title":"Cancer"},{"key":"B3","first-page":"15","article-title":"Extracardiac rhabdomyomas","volume":"11","author":"Willis","year":"1994","journal-title":"Semin Diagn Pathol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1016\/j.amjoto.2010.01.007","article-title":"Adult rhabdomyoma in the parapharyngeal space: report of 2 cases and review of the literature","volume":"32","author":"Papaspyrou","year":"2011","journal-title":"Am J Otolaryngol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1007\/s00455-007-9125-0","article-title":"Rhabdomyoma of the parapharyngeal space presenting with dysphagia","volume":"23","author":"Pichi","year":"2008","journal-title":"Dysphagia"},{"key":"B6","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1002\/hed.20358","article-title":"Adult extracardiac rhabdomyoma: light and immunohistochemical studies of two cases in the parapharyngeal space","volume":"28","author":"Bj\u00f8rndal S\u00f8rensen","year":"2006","journal-title":"Head Neck"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1626816","DOI":"10.1155\/crip\/1626816","article-title":"A rare case of adult rhabdomyoma in the parapharyngeal space: diagnostic challenges and surgical management","volume":"2025","author":"Gatsounia","year":"2025","journal-title":"Case Rep Pathol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1016\/j.oraloncology.2014.02.007","article-title":"A systematic review of 1143 parapharyngeal space tumors reported over 20 years","volume":"50","author":"Riffat","year":"2014","journal-title":"Oral Oncol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1002\/hed.25439","article-title":"Contemporary management of primary parapharyngeal space tumors","volume":"41","author":"L\u00f3pez","year":"2019","journal-title":"Head Neck"},{"key":"B10","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1007\/s11912-019-0853-8","article-title":"Contemporary management of parapharyngeal tumors","volume":"21","author":"Strohl","year":"2019","journal-title":"Curr Oncol Rep"},{"key":"B11","doi-asserted-by":"publisher","first-page":"593","DOI":"10.3390\/curroncol30010078","article-title":"Management of parapharyngeal space tumors: clinical experience and treatment strategy","volume":"30","author":"Jiang","year":"2023","journal-title":"Curr Oncol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1111\/ors.70041","article-title":"Giant lipoma of the neck causing airways compression: a case report","volume":"19","author":"Gilli","year":"2026","journal-title":"Oral Surg"},{"key":"B13","first-page":"1115","article-title":"Rhabdomyoma of the pharyngeal musculature extending into the prestyloid parapharyngeal space","volume":"17","author":"Helmberger","year":"1996","journal-title":"AJNR Am J Neuroradiol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1002\/dc.23860","article-title":"Cytologic findings of an adult rhabdomyoma in the parapharyngeal space: a report of a case and review of the literature","volume":"46","author":"Dermawan","year":"2018","journal-title":"Diagn Cytopathol"},{"key":"B15","first-page":"775","article-title":"Fine needle aspiration of parapharyngeal space adult rhabdomyoma: a case report","volume":"54","author":"Zhang","year":"2010","journal-title":"Acta Cytol"},{"key":"B16","first-page":"883","article-title":"Multifocal adult rhabdomyoma of the neck: a rare entity","volume":"59","author":"Gajda","year":"2005","journal-title":"Otolaryngol Pol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1016\/j.ijom.2020.07.018","article-title":"Multifocal adult rhabdomyoma of the head and neck: case report and systematic review of the literature","volume":"50","author":"Khalaf","year":"2021","journal-title":"Int J Oral Maxillofac Surg"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000013291","article-title":"The return of a rare entity: recurrent neck rhabdomyoma","author":"Joti\u0107","year":"2026","journal-title":"J Craniofac Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1149735","DOI":"10.3389\/fmed.2023.1149735","article-title":"Case report: abrikossoff\u2019s tumor of the facial skin","volume":"10","author":"Ardeleanu","year":"2023","journal-title":"Front Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1822058","DOI":"10.3389\/fmed.2026.1822058","article-title":"A rare case of intramuscular granular cell tumor in the right thigh: case report and literature review","volume":"13","author":"Hou","year":"2026","journal-title":"Front Med"},{"key":"B21","doi-asserted-by":"publisher","first-page":"892","DOI":"10.3390\/diagnostics12040892","article-title":"S-100 immunohistochemical positivity in rhabdomyoma: an underestimated potential diagnostic pitfall in routine practice","volume":"12","author":"Palicelli","year":"2022","journal-title":"Diagnostics"},{"key":"B22","first-page":"E7","article-title":"Adult extracardiac rhabdomyoma of the parapharyngeal space","volume":"91","author":"Khan","year":"2012","journal-title":"Ear Nose Throat J"},{"key":"B23","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/j.otc.2021.03.001","article-title":"Transoral excision of parapharyngeal space tumors","volume":"54","author":"Larson","year":"2021","journal-title":"Otolaryngol Clin North Am"},{"key":"B24","doi-asserted-by":"publisher","first-page":"NP454","DOI":"10.1177\/0145561320923171","article-title":"Transoral excision of parapharyngeal tumors","volume":"100","author":"Lao","year":"2021","journal-title":"Ear Nose Throat J"},{"key":"B25","doi-asserted-by":"publisher","first-page":"2786874","DOI":"10.1155\/crot\/2786874","article-title":"Transoral robotic surgical resection of bilateral parapharyngeal space rhabdomyoma","volume":"2025","author":"Brady","year":"2025","journal-title":"Case Rep Otolaryngol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"2734","DOI":"10.1002\/hed.26127","article-title":"Endonasal endoscopic transpterygoid approach to the upper parapharyngeal space","volume":"42","author":"Li","year":"2020","journal-title":"Head Neck"},{"key":"B27","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1002\/hed.24399","article-title":"Modified endoscopic transnasal-transmaxillary-transpterygoid approach to parapharyngeal space tumor resection","volume":"38","author":"Wasano","year":"2016","journal-title":"Head Neck"},{"key":"B28","doi-asserted-by":"publisher","first-page":"696","DOI":"10.1177\/0194599813520290","article-title":"Endoscopic endonasal transpterygoid transmaxillary approach to infratemporal and upper parapharyngeal tumors","volume":"150","author":"Battaglia","year":"2014","journal-title":"Otolaryngol Head Neck Surg"},{"key":"B29","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1016\/j.amjoto.2017.03.004","article-title":"From transmandibular to transoral robotic approach for parapharyngeal space tumors","volume":"38","author":"Chu","year":"2017","journal-title":"Am J Otolaryngol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"104574","DOI":"10.1016\/j.compbiomed.2021.104574","article-title":"Modeling the effect of tumor compression on airflow dynamics in trachea using contact simulation and CFD analysis","volume":"135","author":"Zobaer","year":"2021","journal-title":"Comput Biol Med"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1945205\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:27:52Z","timestamp":1790310472000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1945205\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,25]]},"references-count":30,"alternative-id":["10.3389\/fmed.2026.1945205"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1945205","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,25]]},"article-number":"1945205"}}