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Cervical Rhabdomyosarcoma with Prolapse in a Young Girl

  • Elizabeth Reshmi John
  • P. Rema
  • J. Siva Ranjith
  • Aswathy G. Nath
  • Vijayshanti
  • Suchetha Sambasivan
Case report
  • 12 Downloads

Abstract

Background

Rhabdomyosarcomas are malignant skeletal muscle tumours. They are rare in adults, but account for about 50% of soft tissue sarcomas in children. Most frequent sites include head and neck (35%), followed by the genitourinary tract (25%), extremities and trunk, and cervix is one of the least common sites in the genitourinary tract.

Case description

We report the case of a 13-year-old girl who was evaluated for excessive discharge per vaginum and was symptomatically treated and later diagnosed as a case of cervical RMS. She developed excess bleeding per vaginum associated with prolapse of the mass for which an emergency excision had to be done. Then, she completed her chemotherapy and is disease free till date.

Conclusion

We report this case due to its unusual presentation. She was initially treated as a case of vaginitis and diagnosis was missed. Once she was diagnosed as having cervical RMS and on chemotherapy, she developed prolapse of the mass with bleeding, which is also an unusual presentation. So cases of excessive discharge per vaginum not responding to treatment should have a detailed pelvic examination to rule out any mass lesions.

Keywords

Embryonal rhabdomyosarcomas Cervical rhabdomyosarcomas Prolapse 

Notes

Compliance with Ethical Standards

Conflict of interest

None.

References

  1. 1.
    Ognjanovic S, Linabery AM, Charbonneau B, et al. Trends in childhood rhabdomyosarcoma incidence and survival in the United States, 1975–2005. Cancer. 2009;115:4218–26.CrossRefGoogle Scholar
  2. 2.
    Daya DA, Scully RE. Sarcoma botryoides of the uterine cervix in young women: a clinicopathological study of 13 cases. Gynecol Oncol. 1988;29:290–304.CrossRefGoogle Scholar
  3. 3.
    Leuschner I, Harms D, Mattke A, et al. Rhabdomyosarcoma of the urinary bladder and vagina. A clinicopathologic study with emphasis on recurrent disease: a report from the Kiel Pediatric Tumor Registry and the German CWS Study. Am J Surg Pathol. 2001;25:856–64.CrossRefGoogle Scholar
  4. 4.
    Walterhouse DO, Meza JL, Breneman JC, et al. Local control and outcome in children with localized vaginal rhabdomyosarcoma: a report from the Soft Tissue Sarcoma Committee of the Children’s Oncology Group. Pediatr Blood Cancer. 2011;57:76–83.CrossRefGoogle Scholar
  5. 5.
    Khosla D, Gupta R, Srinivasan R, Patel F, Rajwanshi A. Sarcomas of uterine cervix: clinicopathological features, treatment, and outcome. Int J Gynecol Cancer. 2012;22:1026–30.CrossRefGoogle Scholar
  6. 6.
    Fletcher C, Bridge J, Hogendroom P, Mertrens F. WHO classification of tumours of soft tissue and bone. IARC: Lyon; 2013.Google Scholar
  7. 7.
    Houghton JP, McCluggage WG. Embryonal rhabdomyosarcoma of the cervix swith focal pleomorphic areas. J Clin Pathol. 2007;60:88–9.CrossRefGoogle Scholar
  8. 8.
    Bernal KL, Fahmy L, Remmenga S, Bridge J, Baker J. Embryonal rhabdomyosarcoma (sarcoma botryoides) of the cervix presenting as a cervical polyp treated with fertility-sparing surgery and adjuvant chemotherapy. Gynecol Oncol. 2004;95:243–6.CrossRefGoogle Scholar
  9. 9.
    Ghaemmaghami F, Karimi Zarchi M, Ghasemi M. Lower genital tract rhabdomyosarcoma: case series and literature review. Arch Gynecol Obstet. 2008;278:65–9.CrossRefGoogle Scholar
  10. 10.
    Sanders MA, Gordinier M, Talwalkar SS, Moore GD. Embryonal rhabdomyosarcoma of the uterine cervix in a 41-year-old woman treated with radical hysterectomy and adjuvant chemotherapy. Gynecol Oncol. 2008;111:561–3.CrossRefGoogle Scholar
  11. 11.
    Enzinger FM. Rhabdomyosarcoma. In: Weiss SW, editor. Soft tissue tumors. 3rd ed. CV Mosby: St Louis; 1995. p. 539–77.Google Scholar
  12. 12.
    Kriseman ML, Wang W-L, Sullinger J, Schmeler KM, Ramirez PT, Herzog CE, Frumovitz M. Rhabdomyosarcoma of the cervix in adult women and younger patients. Gynecol Oncol. 2012;126:351–6.CrossRefGoogle Scholar
  13. 13.
    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.Google Scholar
  14. 14.
    Villella JA, Bogner PN, Jani-Sait SN, Block AM, Lele S. Rhabdomyosarcoma of the cervix in sisters with review of the literature. Gynecol Oncol. 2005;99:742–8.CrossRefGoogle Scholar
  15. 15.
    Ferguson SE, Gerald W, Barakat RR, Chi DS, Soslow RA. Clinicopathologic features of rhabdomyosarcoma of gynecologic origin in adults. Am J Surg Pathol. 2007;31:382–9.CrossRefGoogle Scholar
  16. 16.
    Zrara I, Mounzil CD, Rimani M, Bouzidi A, Labraimi A, Ben OC. Botryoide sarcoma of the uterine cervix. About one case. Gynécol Obstét Fertil. 2002;30:784–6.CrossRefGoogle Scholar
  17. 17.
    Kayton ML, Wexler LH, Lewin SN, Park KJ, La Quaglia MP, Abu-rustum NR. Pediatric radical abdominal trachelectomy for anaplastic embryonal rhabdomyosarcoma of the uterine cervix: an alternative to radical hysterectomy. J Pediatr Surg. 2009;44:862–7.CrossRefGoogle Scholar

Copyright information

© Association of Gynecologic Oncologists of India 2018

Authors and Affiliations

  • Elizabeth Reshmi John
    • 1
  • P. Rema
    • 2
  • J. Siva Ranjith
    • 2
  • Aswathy G. Nath
    • 2
  • Vijayshanti
    • 2
  • Suchetha Sambasivan
    • 2
  1. 1.Department of Obstetrics and GynecologyAzeezia Medical College HospitalMeeyannoor, KollamIndia
  2. 2.Department of Surgical OncologyRegional Cancer CentreThiruvanathapuramIndia

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