Sarcoma Botryoides of the Uterine Cervix in a 46-year-old Woman: Case Report and Literature Review

Abstract

Sarcoma botryoides, which usually occurs in the vagina in childhood, is rare in the female reproductive tract of adult women, especially those over the age of 40. We present a case of sarcoma botryoides of the uterine cervix that was an incidental finding in a 46-year-old woman. The tumor formed a grape-like cervical polyp that was locally excised, but rapidly recurred. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. The myxoid tumor had a cambium layer and was composed of spindle-shaped myoblastic cells without apparent cross-striations. The tumor cells were immunoreactive for MyoD1 and myogenin. Postoperative chemotherapy (vincristine and actinomycin D) was given according to the Intergroup Rhabdomyosarcoma Study protocol, and the patient was alive without recurrence 45 months postoperatively. This is the only the fourth case reported in detail of a sarcoma botryoides of the uterine cervix in a patient over the age of 40.

Embryonal rhabdomyosarcoma of the cervix with focal pleomorphic areas

“…[1][2][3][4][5][6] Sometimes there are multiple polyps. The neoplasm we describe is in keeping with a sarcoma botryoides, a variant of embryonal rhabdomyosarcoma that has a polypoid appearance and originates below a mucous membrane-covered surface, forming a cambium layer.…”

“…E mbryonal rhabdomyosarcoma of the cervix, in contrast with the corresponding tumour in the vagina, usually occurs in women in their late teens and early 20s. [1][2][3][4][5][6] We report a case of cervical embryonal rhabdomyosarcoma in a 30year-old woman. An unusual feature, and the prime reason for reporting this case, was the focal presence of highly pleomorphic cells, which to our knowledge has been described previously only in a single case of cervical embryonal rhabdomyosarcoma.…”

Embryonal Rhabdomyosarcoma of the Uterine Cervix: Two Cases Report and Literature Review

“…This difference has been attributed to a higher proportion of adverse prognostic clinical and pathological factors, and to inadequate treatment given to adults with RMS [13]. Our patients are older than most of the cases that have been reported concerning embryonal RMS in women older than 40 [4]- [8]. One has been reported in a HIV positive 45-year-old widow and the onset of the tumor at this late age was thought to the due to the patient's HIV positive status and poor state of well-being.…”

“…It rarely occurs in the cervix or the uterus and is usually seen in female infants and young children [3]. Few cases of embryonal RMS in women older than 40 years have been described [4]- [8]. We report two cases diagnosed at our center, in perimenopausal women, with different evolution: successful surgery in the first case and a poor prognosis despite the chemotherapy in the second one.…”

Alveolar Rhabdomyosarcoma of the Uterine Cervix. A Case Report Confirmed by FKHR Break-Apart Rearrangement Using a Fluorescence In Situ Hybridization Probe on Paraffin-Embedded Tissues

“…However, initially, they contain PAS-diastase-positive intracytoplasmatic rods and granules having an indolent clinical course and a relatively good prognosis. Embryonal rhabdomyosarcoma occurs in teenagers and young adults, and on microscopic examination, the tumor is myxoid, with a subepithelial cambium of increased cellularity (9). Most ARMS exhibit 2 consistent chromosomal translocations, t(2;13) (q35;q14), in nearly 85% of cases and the less frequent t(1;13)(p36;q14), resulting in the fusion genes PAX3-FKHR and PAX7-FKHR, respectively.…”