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Case Reports
. 2024 Jun:119:109742.
doi: 10.1016/j.ijscr.2024.109742. Epub 2024 May 9.

A challenging diagnosis and treatment of embryonal rhabdomyosarcoma in the cervix of an adult woman: A surgical case report

Hamza Messaoudi  1 , Abdelhamid Benlghazi  2 , Abderrahim Elktaibi  3 , Moad Belouad  1 , Elhassani Moulay Mehdi  1 , Jaouad Kouach  1
Affiliations
Case Reports

A challenging diagnosis and treatment of embryonal rhabdomyosarcoma in the cervix of an adult woman: A surgical case report

Hamza Messaoudi et al. Int J Surg Case Rep. 2024 Jun.

Abstract

Introduction and importance: Embryonal Rhabdomyosarcoma is a rare form of sarcoma mainly seen in children and adolescents. In the specific case of the cervix, embryonal Rhabdomyosarcoma is an extremely rare mesenchymal tumor, accounting for <1 % of all cervical cancers. This highly malignant tumor mainly affects adolescents and young adults.

Case presentation: We describe the case of a 29-year-old woman with embryonal rhabdomyosarcoma of the cervix, which manifested as an exophytic cervical mass. Histopathological and immunohistochemical findings confirmed the presence of embryonal rhabdomyosarcoma of the cervix. This patient was successfully treated with a combination of neoadjuvant chemoradiotherapy, total abdominal hysterectomy with bilateral ovary transposition, and adjuvant chemoradiotherapy.

Clinical discussion: Embryonal Rhabdomyosarcoma of the cervix may manifest by vaginal bleeding, a cervical mass and pelvic symptoms. The diagnosis is confirmed by histopathology and immunohistochemistry. With multimodal treatment including surgery, chemotherapy and radiotherapy, outcomes improve for patients.

Conclusions: Uterine cervix embryonal RMS is an uncommon cancer in adult patients. While rare, it should be considered as a potential diagnosis in patients presenting with vaginal bleeding and a significant cervical polyp. Histopathology, complemented by relevant immunohistochemistry, is crucial for accurately detecting the tumor and guiding appropriate management strategies.

Keywords: Adult sarcoma; Embryonal rhabdomyosarcoma; Rhabdomyosarcoma; Surgery; Uterine rhabdomyosarcoma.

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Conflict of interest statement

Declaration of competing interest The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
(a): Magnetic resonance image of the cervix mass: sagittal section. (b): Magnetic resonance image of the cervix mass: transverse section.
Fig. 2
Fig. 2
Hysteroscopic image revealed a huge mass on the anterior lip of the cervix, filling the vagina.
Fig. 3
Fig. 3
(a): Histopathological examination: Microphotography showing multinucleated, bizarre, eosinophilic and polygonal cells (H&E, 20×) (b): Microphotography showing a positive immunohistochemistry for myogenin (400×).
Fig. 4
Fig. 4
Abdominopelvic CT scan after three cycles of chemotherapy showed a 65 % reduction in tumor volume.
Fig. 5
Fig. 5
Image showing macroscopic aspect of hysterectomy specimen: we note the presence of a mass in the anterior lip of the cervix.
See this image and copyright information in PMC

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