Embryonal rhabdomyosarcoma of the neck masquerading as a congenital lymphangioma in a pediatric patient

The diagnosis of lymphangioma is typically based on history, exam, and imaging. Biopsy is rarely sought due to the accuracy of clinical diagnosis. We report a 4-year-old male with Gorlin syndrome, who presented with a neck mass that was clinically diagnosed as a lymphangioma. Sclerotherapy was performed at the family's request. After the procedure, necrosis developed over the surface of the mass. Surgical excision was then performed, and pathology interpreted as embryonal rhabdomyosarcoma. The presentation allowed this rhabdomyosarcoma to masquerade as a lymphangioma. This unusual presentation brings into question the use of fine needle aspiration in suspected lymphangiomas.