Abstract
Background: Rhabdomyosarcoma (RMS) is a rare soft tissue sarcoma that primarily affects children and adolescents. Adult RMS is uncommon and associated with poorer prognosis and limited evidence to guide rehabilitation.
Case Description: A 29-year-old male presented with right facial pain, hearing loss, tinnitus, and right facial and tongue paresthesia. Imaging and biopsy revealed spindle cell RMS of the right masticator space. He had no cancer-related family history, did not smoke, and used alcohol occasionally. Treatment included neoadjuvant chemotherapy, major oncologic resection with scapular free flap reconstruction, and adjuvant radiation. He was referred to outpatient physical therapy with trismus, restricted cervical and shoulder range of motion (ROM), right upper extremity (UE) weakness with scapular winging, facial droop, head and neck lymphedema, pain, and scar adhesions. Interventions included manual lymphatic drainage, cervical and scapular stabilization, ROM exercises, scar mobilization, progressive resistance training, temporomandibular joint (TMJ) mobilization, and static stretching for trismus using a home device.
Outcomes: Despite fluctuations related to radiation side effects and a second surgery, the patient demonstrated meaningful improvements in mandibular depression, cervical and shoulder ROM, lymphedema volume, strength, and function. Facial droop and lagophthalmos resolved spontaneously. He returned to premorbid activities including hiking, gym-based strength training, and his Doctor of Physical Therapy (DPT) program.
Discussion: This case illustrates the role of specialized oncologic and lymphedema-focused rehabilitation in an adult with rare head and neck RMS. Individualized, closely monitored physical therapy contributed to restoration of function despite complex medical course. Further research is needed to guide evidence-based rehabilitation and to better characterize recurrence and functional outcomes in adults with RMS.
First Page
10
Last Page
25
DOI
10.26890/ktgz2625
Recommended Citation
Carrano J. Physical Therapy Management of an Adult Patient Diagnosed with Spindle Cell Rhabdomyosarcoma: A Case Report. Oncology Rehabilitation in Practice. 2026; 3(1):10-25. doi: 10.26890/ktgz2625.