Rhabdomyosarcoma of the Cervix, Local Excision or Radical Surgery (Report of Two Cases and Review of the Literature)

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.

Uterine embryonal rhabdomyosarcoma in adult women: a case report on the challenging diagnosis and treatment

“…There is no specific technique for diagnosis and staging of uERMS. The most common imaging used is MRI with a tumor detection rate of 83% [ 13 , 15 , 22 , 23 , 24 , 25 , 26 ]. In fact, the main advantage of MRI is its ability to evaluate tumor depth invasion preoperatively, as is already the case for endometrial and cervical cancer [ 22 , 23 , 24 , 25 , 26 ].…”