Rhabdomyosarcoma is a rare soft tissue tumor that was found incidentally in a repaired cleft palate oronasal fistula of a 3-year-old boy. This situation has yet to be reported in the literature. During this fistula repair, a small piece of tissue was sent for routine pathology, which showed embryonal rhabdomyosarcoma. A literature review as well as diagnostic and treatment algorithms are discussed concerning management of this rare malignancy. Also, routine pathology should be reviewed carefully because unsuspected tissues may have pathologic findings that dramatically affect patient diagnosis and management.
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