Autopsy and Case Reports
https://www.autopsyandcasereports.org/article/doi/10.4322/acr.2023.419
Autopsy and Case Reports
Clinical Case Report and Review

Embryonal rhabdomyosarcoma of the uterine cervix in an adult female

Toyaja Jadhav; Manoj Gopal Madakshira; Sushil Garud

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Abstract

Embryonal rhabdomyosarcoma (RMS) of the female genital tract is an uncommon malignancy, presenting mainly in the pediatric and adolescent populations, primarily affecting the first two decades of life. This malignancy presentation in adulthood is rare and is seldom seen. The incidence of this tumor affecting adult females is approximately 0.4 - 1%, with the common site being the vagina. This tumor infrequently involves the cervix. RMS has a poor survival rate and once diagnosed, it requires aggressive management by radical surgery accompanied by chemoradiation. We present a case of an anaplastic variant of embryonal RMS of the uterine cervix presenting as a cervical polyp in a 36-year-old female who complained of dyspareunia and post-coital bleeding.

Keywords

Rhabdomyosarcoma, Embryonal, Uterine Cervical Diseases, Sarcoma, Cervical Cancer, Uterine Cervical Neoplasms

References

1 Jayi S, Bouguern H, Fdili FZ, 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(1):241. http://dx.doi.org/10.1186/1752-1947-8-241. PMid:24986146.

2 Shim AR, Lee M, Paek JH, Kim MJ, Kim SW. A case of embryonal rhabdomyosarcoma of the uterine cervix in a middle-aged woman. Korean Journal of Obstetrics & Gynecology. 2011;54(11):707. http://dx.doi.org/10.5468/KJOG.2011.54.11.707.

3 Gomes AR, Leite PB, Rocha JS, et al. Embryonal rhabdomyosarcoma of the uterine cervix: a rare case report. Int J Reprod Contracept Obstet Gynecol. 2016;6(1):309. http://dx.doi.org/10.18203/2320-1770.ijrcog20164683.

4 Mousavi A, Akhavan S. Sarcoma botryoides (embryonal rhabdomyosarcoma) of the uterine cervix in sisters. J Gynecol Oncol. 2010;21(4):273-5. http://dx.doi.org/10.3802/jgo.2010.21.4.273. PMid:21278891.

5 Horn RC Jr, Enterline HT. Rhabdomyosarcoma: a clinicopathological study and classification of 39 cases. Cancer. 1958;11(1):181-99. http://dx.doi.org/10.1002/1097-0142(195801/02)11:1<181::AID-CNCR2820110130>3.0.CO;2-I. PMid:13500314.

6 Rudzinski ER, Anderson JR, Hawkins DS, Skapek SX, Parham DM, Teot LA. The world health organization classification of skeletal muscle tumors in pediatric rhabdomyosarcoma a report from the children’s oncology group. Arch Pathol Lab Med. 2015;139(10):1281-7. http://dx.doi.org/10.5858/arpa.2014-0475-OA. PMid:25989287.

7 Buruiana FE, Gupta B, Singh K. Rhabdomyosarcoma of the cervix in teenagers - Is fertility preservation a feasible option? Gynecol Oncol Rep. 2020;34:100677. http://dx.doi.org/10.1016/j.gore.2020.100677. PMid:33304979.

8 Qualman S, Lynch J, Bridge J, et al. Prevalence and clinical impact of anaplasia in childhood rhabdomyosarcoma: a report from the Soft Tissue Sarcoma Committee of the Children’s Oncology Group. Cancer. 2008;113(11):3242-7. http://dx.doi.org/10.1002/cncr.23929. PMid:18985676.

9 Shenoy A, Alvarez E, Chi YY, et al. The prognostic significance of anaplasia in childhood rhabdomyosarcoma: a report from the Children’s Oncology Group. Eur J Cancer. 2021;143:127-33. http://dx.doi.org/10.1016/j.ejca.2020.10.018. PMid:33302115.

10 Cramer SL, Miller AL, Pressey JG, et al. Pediatric anaplastic embryonal rhabdomyosarcoma: targeted therapy guided by genetic analysis and a patient-derived xenograft study. Front Oncol. 2018;7(JAN):327. http://dx.doi.org/10.3389/fonc.2017.00327. PMid:29376028.

11 Kaseb H, Kuhn J, Babiker HM. StatPearls. Treasure Island (FL): StatPearls Publishing; 2022.

12 Connor EV, Disilvestro PA. Obstetrics and gynaecology cases-reviews diagnosis and management of embryonal rhabdomyosarcoma in a woman with prolapsing cervical mass. Obstet Gynecol Cases Rev. 2015;2(4):4. http://dx.doi.org/10.23937/2377-9004/1410050.

13 Khosla D, Gupta R, Srinivasan R, Patel FD, Rajwanshi A. Sarcomas of uterine cervix: clinicopathological features, treatment, and outcome. Int J Gynecol Cancer. 2012;22(6):1026-30. http://dx.doi.org/10.1097/IGC.0b013e31825a97f6. PMid:22740005.

14 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. http://dx.doi.org/10.1038/modpathol.2011.185. PMid:22157934.

15 Bahall V, de Barry L, Sankar S. A rare case of embryonal rhabdomyosarcoma of the uterine cervix. Case Rep Pathol. 2022;2022:8459566. http://dx.doi.org/10.1155/2022/8459566. PMid:35464884.

16 Apellaniz-Ruiz M, McCluggage WG, Foulkes WD. DICER1‐associated embryonal rhabdomyosarcoma and adenosarcoma of the gynecologic tract: pathology, molecular genetics, and indications for molecular testing. Genes Chromosomes Cancer. 2021;60(3):217-33. http://dx.doi.org/10.1002/gcc.22913. PMid:33135284.

17 Clay MR. Soft tissue; Skeletal muscle Rhabdomyosarcoma; Embryonal rhabdomyosarcoma. [place unknown]; 2022 [cited 2022 Oct 22]. Available from: https://www.pathologyoutlines.com/topic/softtissueembryonalrhabdo.html

18 Ibrahim U, Saqib A, Mohammad F, et al. Embryonal rhabdomyosarcoma of the cervix: a rare disease at an uncommon age. Cureus. 2017;9(11):e1864. http://dx.doi.org/10.7759/cureus.1864. PMid:29375950.

19 Meng L, Zhang Q, Han Q, Sun X, Liu Y, Huang X. Embryonic cervical rhabdomyosarcoma complicated with uterine inversion with cerebral venous sinus thrombosis as the first symptom: a case report and literature review. J Int Med Res. 2021;49(8):3000605211031776. http://dx.doi.org/10.1177/03000605211031776. PMid:34369193.

20 Gibson MC, Nasiri N. Rhabdomyoma. Vienna: WikiDoc; 2019 [cited 2023 Jan 4]. Available from: https://www.wikidoc.org/index.php/Rhabdomyoma

21 Elliott G, Reynolds H, Fidler H. Pseudo-sarcoma botryoides of cervix and vagina in pregnancy*. J Obstet Gynaecol Br Commonw. 1967;74(5):728-33. http://dx.doi.org/10.1111/j.1471-0528.1967.tb03787.x. PMid:6058536.

22 Heller A, Ukazu A, Wang Q. Pseudosarcomatous vaginal polyp: a benign mimic of malignancy. Int J Surg Pathol. 2016;1(2):1-2.

23 Lindberg M, Lucas D, Gardner JM, Cassarino D, Stallings-Archer K. Diagnostic pathology: soft tissue tumours. 2nd ed. Local: Elsevier; 2016. p. 372-7: Embryonal Rhabdomyosarcoma.

24 Narayana Kurup JK, Kamble VC, Acharya AM, Bhat AK. Massive embryonal rhabdomyosarcoma of the hand in an infant with metastasis at birth: management dilemma. Hand (N Y). 2017;12(5):NP109-12. http://dx.doi.org/10.1177/1558944716685827. PMid:28718313.

25 Norris HJ, Taylor HB. Polyps of the vagina. A benign lesion resembling sarcoma botryoides. Cancer. 1966;19(2):227-32. http://dx.doi.org/10.1002/1097-0142(196602)19:2<227::AID-CNCR2820190214>3.0.CO;2-W. PMid:5905466.

26 Health Jade. Rhabdomyoma [place unknown]; c2019 [cited 2023 Jan 4]. Available from: https://healthjade.net/rhabdomyoma/

27 Song JS, Song DE, Kim KR, Ro JY. Cellular pseudosarcomatous fibroepithelial stromal polyp of the vagina during pregnancy: a lesion that is overdiagnosed as a malignant tumor. Korean J Pathol. 2012;46(5):494-8. http://dx.doi.org/10.4132/KoreanJPathol.2012.46.5.494. PMid:23136578.

28 Wyant T, Alteri R, Kalidas M, et al. Rhabdomyosarcoma causes, risk factors, and prevention[place unknown]; 2018 [cited 2022 Oct 22]. Available from: https://www.cancer.org/content/dam/CRC/PDF/Public/8804.00.pdf

29 National Cancer Institute. Childhood Rhabdomyosarcoma Treatment (PDQ®)-Patient Version. [place unknown]; 2022 [cited 2022 Oct 22]. Available from: https://www.cancer.gov/types/soft-tissue-sarcoma/hp/adult-soft-tissue-treatment-pdq

30 Wang X, Feng J, Li Z, Zhang X, Chen J, Feng G. Characteristics and prognosis of embryonal rhabdomyosarcoma in children and adolescents: an analysis of 464 cases from the SEER database. Pediatr Investig. 2020;4(4):242-9. http://dx.doi.org/10.1002/ped4.12220. PMid:33376951.

31 Caruso RA, Napoli P, Villari D, Starrantino M. Anaplastic (pleomorphic) subtype embryonal rhabdomyosarcoma of the cervix. Arch Gynecol Obstet. 2004;270(4):278-80. http://dx.doi.org/10.1007/s00404-003-0504-y. PMid:12942264.

32 Chapell DB. Uterus: other mesenchymal tumors - Undifferentiated uterine sarcoma. [place unknown]; 2021 [cited 2022 Oct 22]. Available from: https://www.pathologyoutlines.com/topic/uterussarcoma.html

33 Han L, Benett J. Uterus Stromal tumors: high grade endometrial stromal sarcoma. [place unknown]; 2021 [cited 2022 Oct 22]. Available from: https://www.pathologyoutlines.com/topic/uterusESShighgrade.html

34 Rawish KR, Fadare O. Dedifferentiated leiomyosarcoma of the uterus with heterologous elements: a potential diagnostic pitfall. Case Rep Obstet Gynecol. 2012;2012:534634. http://dx.doi.org/10.1155/2012/534634. PMid:23119198.

35 Özen ÖI, Ayhan A. Uterus: mixed epithelial and mesenchymal tumors - Müllerian adenosarcoma. [place unknown]; 2021 [cited 2022 Oct 22]. Available from: https://www.pathologyoutlines.com/topic/cervixadenosarcoma.html

36 Iihara K, Hirano K, Fujioka Y, Sakamoto A. Leiomyosarcoma with dedifferentiation in a premenopausal patient discovered after uterine artery embolization. Pathol Int. 2007;57(10):681-7. http://dx.doi.org/10.1111/j.1440-1827.2007.02157.x. PMid:17803657.

37 Nicolas MM, Tamboli P, Gomez JA, Czerniak BA. Pleomorphic and dedifferentiated leiomyosarcoma: clinicopathologic and immunohistochemical study of 41 cases. Hum Pathol. 2010;41(5):663-71. http://dx.doi.org/10.1016/j.humpath.2009.10.005. PMid:20004935.

38 Shankar V. Soft tissue: smooth muscle - Leiomyosarcoma; Leiomyosarcoma-general[place unknown]; 2022 [cited 2022 Oct 22]. Available from: https://www.pathologyoutlines.com/topic/softtissueleiomyosarcoma.html

39 Allanson ER, Cummings M, Kuchel A, Wastney T, Nicklin J. Undifferentiated uterine sarcoma: a multidisciplinary challenge. Int J Gynecol Cancer. 2022;32(2):198-202. http://dx.doi.org/10.1136/ijgc-2021-003215. PMid:35131912.

40 Zhang Y, Chen C, Ren M, Cong X, Li Z, Yang L. Treatment of uterine high-grade endometrial stromal sarcoma with apatinib combined with chemotherapy: a case report. Medicine (Baltimore). 2019;98(13):e15050. http://dx.doi.org/10.1097/MD.0000000000015050. PMid:30921232.

41 Shi Y, Liu Z, Peng Z, Liu H, Yang K, Yao X. The diagnosis and treatment of Mullerian adenosarcoma of the uterus. Aust N Z J Obstet Gynaecol. 2008;48(6):596-600. http://dx.doi.org/10.1111/j.1479-828X.2008.00914.x. PMid:19133051.

42 Juhasz-Böss I, Gabriel L, Bohle RM, Horn LC, Solomayer EF, Breitbach GP. Uterine Leiomyosarcoma. Oncol Res Treat. 2018;41(11):680-6. http://dx.doi.org/10.1159/000494299. PMid:30321869.

43 Chen J, Liu X, Lan J, et al. Rhabdomyosarcoma in adults: case series and literature review. Int J Womens Health. 2022;14:405-14. http://dx.doi.org/10.2147/IJWH.S352143. PMid:35370426.

44 American Cancer Society. Uterine sarcoma early detection, diagnosis, and staging. [place unknown]; 2022 [cited 2022 Oct 22]. Available from: https://www.cancer.org/content/dam/CRC/PDF/Public/8860.00.pdf

45 Varghese M, Bruland O, Wiedswang AM, et al. Metastatic mesenteric dedifferentiated leiomyosarcoma: a case report and a review of literature. Clin Sarcoma Res. 2016;6(1):2. http://dx.doi.org/10.1186/s13569-016-0042-6. PMid:26913180.

46 Seagle BLL, Kanis M, Strohl AE, Shahabi S. Survival of women with Mullerian adenosarcoma: a national cancer data base study. Gynecol Oncol. 2016;143(3):636-41. http://dx.doi.org/10.1016/j.ygyno.2016.10.013. PMid:27771166.

47 Zhang YY, Li Y, Qin M, Cai Y, Jin Y, Pan LY. High-grade endometrial stromal sarcoma: a retrospective study of factors influencing prognosis. Cancer Manag Res. 2019;11:831-7. http://dx.doi.org/10.2147/CMAR.S187849. PMid:30697075.

48 Shankar V. Soft tissue; Skeletal muscle - Rhabdomyoma; Adult type rhabdomyoma. [place unknown]; 2021 [cited 2022 Oct 22]. Available from: https://www.pathologyoutlines.com/topic/softtissueadultrhabdomyoma.html

49 Shankar V. Soft tissue: Skeletal muscle - Rhabdomyoma; Genital type rhabdomyoma. [place unknown]; 2021 [cited 2022 Oct 22]. Available from: https://www.pathologyoutlines.com/topic/softtissuegenitalrhabdomyoma.html

50 Neha B, Manjunath AP, Girija S, Pratap K. Botryoid Rhabdomyosarcoma of the cervix: case report with review of the literature. Sultan Qaboos Univ Med J. 2015;15(3):e433-7. http://dx.doi.org/10.18295/squmj.2015.15.03.022. PMid:26357564.
 


Submitted date:
10/22/2022

Accepted date:
01/04/2023

Publication date:
01/27/2023

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