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Review
. 2023 Jan 30:13:e2023419.
doi: 10.4322/acr.2023.419. eCollection 2023.

Embryonal rhabdomyosarcoma of the uterine cervix in an adult female

Toyaja Jadhav  1 , Manoj Gopal Madakshira  2 , Sushil Garud  3
Affiliations
Review

Embryonal rhabdomyosarcoma of the uterine cervix in an adult female

Toyaja Jadhav et al. Autops Case Rep. .

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: Cervical Cancer; Rhabdomyosarcoma, Embryonal; Sarcoma; Uterine Cervical Diseases; Uterine Cervical Neoplasms.

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Conflict of interest statement

Conflict of interest: None.

Figures

Figure 1
Figure 1. Photomicrographs of the cervical polyp. A - Scanner view shows a stromal tumor composed of marked cytological atypia in the form of nuclear pleomorphism, high N:C ratio, and markedly pleomorphic cells with scant cytoplasm and bizarre nuclei, with the presence of binucleation and fetoid cells with conspicuous nucleoli (H&E; 40x); B - shows the presence of nuclear pleomorphism and atypia with the presence of fetoid/embryonal cells and atypical mitotic figures (H&E; 100x); C - shows stromal tumor cells surrounding an endometrial gland (H&E; 100x); D - shows a fetoid tumor cell with nuclear irregularity, high N:C ratio and presence of multiple conspicuous nucleoli present among surrounding tumor cells (H&E; 400x).
Figure 2
Figure 2. Photomicrographs of the cervical polyp. A - shows immunoreactivity to Desmin (100x); B - Vimentin (100x), and C - Myogenin (100x); D - negative reaction to CK7 (100x).
Figure 3
Figure 3. PET CT of the patient shows in A (sagittal) and B (axial) - a well-defined, slightly lobulated non-FDG avid lesion within the endocervical canal involving the posterior lip of the cervix and extending into the posterior cervical myometrium measuring 3.9x4x3.3cm, without invading into the uterus, urinary bladder, and the surrounding lymph nodes.
Figure 4
Figure 4. Gross image of the resected uterus after TAH+BSO with the external surface of the uterus and cervix appearing smooth (A) (scale bar= 10 cm); and the cut surface showing a cervical tumor (arrow), extending into the lower uterine segment (B) (scale bar= 10cm).
See this image and copyright information in PMC

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