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Unusual association of diseases/symptoms
Case report
Oropharyngeal rhabdomyoma: the cause of severe sleep apnoea?
  1. Henrik Jonathan Münch1,
  2. Padraig O'Leary1,
  3. Jesper Bille2 and
  4. Thomas Kjaergaard2
  1. 1Department of Otorhinolaryngology, Aarhus Universitetshospital, Aarhus, Denmark
  2. 2Department of Otorhinolaryngology, Aarhus University Hospital, Aarhus, Denmark
  1. Correspondence to Dr Henrik Jonathan Münch; Henrmu{at}rm.dk

Abstract

This case report presents an elderly male patient who on diagnosis with a large oropharyngeal tumour had no specific symptomatology apart from severe obstructive sleep apnoea. Histopathology revealed the tumour to be an adult rhabdomyoma, a rare but benign tumour arising from striated muscle cells. The tumour obstructed most of the oropharyngeal space and almost occluded the patient’s airway when lying in a supine position. The patient was deemed operable, and the tumour was excised in toto using a transoral robotic surgery system. On follow-up, the patient had a severe reduction of apnoeas/hypopnoeas and felt subjectively ‘reborn’. This is to our knowledge the first case where an adult rhabdomyoma is removed using a robot-assisted approach, thus presenting a new and viable option when considering removal of benign tumours of the pharynx leading to a very minor degree of morbidity for the patients.

  • ear, nose and throat
  • sleep disorders (respiratory medicine)
  • head and neck surgery
  • otolaryngology / ENT

https://doi.org/10.1136/bcr-2019-230949

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    Footnotes

    • Contributors All registered authors contributed significantly in the production of this case report. All authors have approved the submitted draft. The corresponding author HJM has written and finalised the main text including learning objectives. JB was the primary examining clinician and in-hospital director of sleep medicine. PO did the initial direct laryngoscopy and biopsy and contributed to the transoral robotic surgery (TORS) operability assessment as well as obtained the patient consent. TK is the in-hospital primary TORS surgeon, finalised the operability assessment and facilitated the resection of the tumour as well as contributed with the TORS specific details in the 'treatment' section of the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.