P PERS OTORRHEA X FACIAL PALSY RED FLAG

 A

3 Key Points

1. Hidden malignancy behind “chronic ear infection” symptoms
   Pediatric temporal bone rhabdomyosarcoma can initially mimic otitis media or otitis externa, often presenting with persistent otorrhea (ear discharge) and facial nerve palsy, which are red-flag signs beyond routine infection.

2. Imaging and diagnostic delay is a major issue
   The systematic review of 68 cases shows that diagnosis is often delayed because symptoms resemble benign ear disease. Early MRI/CT imaging and biopsy are critical when symptoms are atypical, persistent, or progressive.

3. Multimodal treatment is required for survival
   Management typically involves a combination of surgery, chemotherapy, and radiotherapy, reflecting the aggressive nature of rhabdomyosarcoma and the need for coordinated oncologic care in pediatric patients.