Iranian Society of Gynecology Oncology

Authors

1 Department of Obstetrics and Gynecology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran

2 Department of Obstetrics and Gynecology, Arash Women Hospital, Tehran University of Medical Sciences, Tehran, IR Iran

Abstract

Introduction: Embryonal (Botryoid) Rhabdomyosarcoma (RMS) is an aggressive malignancy that arises from embryonal rhabdomyoblasts. It is commonly seen in the genital tract of female infants and young children. The primary site of these tumors is closely related to the age of the patient. Embryonal Rhabdomyosarcoma has a marked tendency for local recurrence after excision. Due to young age of affected patients who desire fertility, the management of this rapidly growing malignancy is very critical and poses challenges.
Case Presentation: We report on two cases embryonal rhabdomyosarcoma of uterine cervix, who were referred to Imam Khomeini hospital during year 2014. Both of them were young virgin females. The presenting symptom for both was vaginal bleeding and protrusion of polypoid mass from the hymen. After neoadjuvant chemotherapy, radical hysterectomy was offered to them. One of them refused, thus local excision was done. Both patients received adjuvant chemotherapy yet in the patient with local excision, the tumor recurred with multiple metastases.
Conclusions: There are several methods of surgical approach and variation in adjuvant therapy in the management of embryonal rhabdomyosarcoma. If we choose a conservative approach for surgery of early stage, surgical margin should be negative and in other cases doing radical surgery is the best.

Keywords

  1. Bajpai N, Attibele P. Botryoid Rhabdomyosarcoma of the Cervix. Sultan Qaboos Univ. Med J. ;15(3):433-7.
  2. Li RF, Gupta M, McCluggage WG, Ronnett BM. Embryonal rhabdomyosarcoma (botryoid type) of the uterine corpus and cervix in adult women: report of a case series and review of the literature. Am J Surg Pathol. 2013;37(3):344-55. [DOI:10.1097/PAS.0b013e31826e0271]
  3. Mousavi A, Akhavan S. Sarcoma botryoides (embryonal rhabdomyosarcoma) of the uterine cervix in sisters. J Gynecol Oncol. 2010;21(4):273-5. doi: 10.3802/jgo.2010.21.4.273. [DOI:10.3802/jgo.2010.21.4.273]
  4. Behtash N, Mousavi A, Tehranian A, Khanafshar N, Hanjani P. Embryonal rhabdomyosarcoma of the uterine cervix: case report and review of the literature. Gynecol Oncol. 2003;91(2):452-5. [DOI:10.1016/S0090-8258(03)00539-0]
  5. Narin MA, Karalok A, Basaran D, Turkmen O, Tutan T, Tulunag G. Embryonal Rhabdomyosarcoma of the cervix in young women. J Adolese young Adult Oncol. 2016. [DOI:10.1089/jayao.2015.0066]
  6. Sobiczewski P, Danska-Bidzinska A, Miedzinska M, Olszewski W, Bidzinski M. Polypectomy followed by adjuvant chemotherapy in a patient with sarcoma botryoides of the uterine cervix-case report and review of the literature. Ginekol Pol. 2011;82(11):857-61.
  7. Dehner LP, Jarzembowski JA, Hill DA. Embryonal rhabdomyosarcoma of the uterine cervix: a report of 14 cases and a discussion of its unusual clinicopathological associations. Mod Pathol. 2012;25(4):602-14. [DOI:10.1038/modpathol.2011.185]
  8. Gordon AN, Montag TW. Sarcoma botryoides of cervix: Excision followed by adjuvant chemotherapy for preservation of reproductive function. Gynecol Oncol. 1990;36:119-20. [DOI:10.1016/0090-8258(90)90121-Z]
  9. Copeland LJ, Gershenson DM, Saul PB, Sneige N, Stringer CA, Edwards CL. Sarcoma botryoides of the female genital tract. Obstet Gynecol. 1985;66(2):262-6.
  10. Daya DA, Scully RE. Sarcoma botryoides of the uterine cervix in young women: a clinicopathological study of 13 cases. Gynecol Oncol. 1988;29(3):290-304. [DOI:10.1016/0090-8258(88)90228-4]
  11. Jayi S, Bouguern H, Fdili FZ, Chaara H, Chbani L, Hafidi I, et al. Embryonal rhabdomyosarcoma of the cervix presenting as a cervical polyp in a 16-year-old adolescent: a case report. J Med Case Rep. 2014;8:241. [DOI:10.1186/1752-1947-8-241]