Sarcoma botryoides: MRI findings in two patients

Abstract

We report the magentic resonance (MR) findings of sarcoma botryoides in two young pediatric patients with this tumor. There has been very little literature regarding the MR appearance of this subtype of rhabdomyosarcoma. In both cases, the tumor was vaginal in origin, as would be expected in this age group. We found areas of bright T2 signal within these lesions, intermixed with areas of lower T2-signal tissue, which showed considerable enhancement. These imaging findings are reflective of the histologic architecture of these lesions, which are composed of separate myxoid and subepithelial cellular zones. In both cases, the extent of the tumor and lack of local invasion or metastatic disease were confirmed surgically, and both patients have undergone multiple postoperative MR studies that have shown lack of residual, recurrent, or metastatic disease.

Multimodality imaging of vaginal rhabdomyosarcoma

“…Sarcoma botryoides is usually reported as a vaginal tumor in female reproductive tract of infants,[6] and is the most common malignancy arising in the GU tract of the pediatric population prior to the age of 15. [7] Vaginal bleeding is the most common presenting feature even though nonspecific. It may also present as a polypoid or fleshy mass in the vagina, or more classically projecting from the introitus.…”

“…The high T2 signal due to abundant myxoid stroma within these tumors may give it a multiseptated cystic appearance and suggest the botryoid variant. [7] On postcontrast imaging RMS demonstrate strong enhancement. In very rare instances, the tumor may show a predominantly cystic appearance.…”

Radiologic Evaluation of Mesenchymal Tumors of the Female Genital Tract

“…It grows as a grapelike mass with mixed high and low intensity on T2-weighted MR, and significant enhancement. 45 The imaging features of adult rhabdomyosarcomas have not been well studied. They have been reported to show a large uterine tumor with intermediate marbled background of T2-signal intensity with pockets of high T2-signal intensity.…”

Imaging of Rare Gynecologic Tumors

“…Of these, a subtype, sarcoma botryoides (embryonal rhabdomyosarcoma), is the most common gynecologic malignancy in patients younger than 15 [44]. Of these, a subtype, sarcoma botryoides (embryonal rhabdomyosarcoma), is the most common gynecologic malignancy in patients younger than 15 [44].…”