EC Paediatrics

Persistent otorhinolaryngological (ENT) symptoms in children are usually attributed to benign conditions but may rarely conceal malignant diseases, leading to delayed diagnosis and poor outcomes. We report the case of a 3-year-old child who presented with progressive nasal obstruction and snoring, initially managed as allergic rhinitis and adenoid hypertrophy. Despite adenoidectomy with non-malignant histopathological findings, the child’s condition deteriorated, with respiratory distress, weight loss, bilateral epistaxis, cervical lymphadenopathy, and neurological signs. Further investigations revealed an extensive nasopharyngeal mass with locoregional invasion and pulmonary metastases. Histopathological and immunohistochemical analyses confirmed embryonal rhabdomyosarcoma. Despite initiation of chemotherapy, the disease progressed rapidly, resulting in death. This case highlights the need for heightened clinical vigilance, early endoscopic evaluation, and multidisciplinary management when ENT symptoms persist or worsen in children.

 Keywords: Otorhinolaryngological (ENT); Adenoid Hypertrophy; Nasopharyngeal Rhabdomyosarcoma

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