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Essetti S, Faraj C, Lahlou I, Chait F, Bahlouli N, Allali N, Haddad SE, Chat L. Vaginal botryoid rhabdomyosarcoma in an infant: A case report and review of the literature. Radiol Case Rep 2024; 19:5794-5797. [PMID: 39308616 PMCID: PMC11416461 DOI: 10.1016/j.radcr.2024.08.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 08/14/2024] [Accepted: 08/18/2024] [Indexed: 09/25/2024] Open
Abstract
Botryoid rhabdomyosarcoma is a rare and aggressive malignancy that primarily affects the female genital tract in children. It arises from embryonal rhabdomyoblasts. The vagina is the most common site, but it can also occur, although rarely, in the cervix or uterine fundus. We report the case of a 2-year-old girl who presented with a rapidly growing mass in the vulvar region. A pelvic MRI revealed a grape-like mass occupying the vaginal lumen, suggestive of botryoid rhabdomyosarcoma. Biopsy of the mass confirmed the diagnosis.
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Affiliation(s)
- Sara Essetti
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina, Hospital, Mohamed V University, Rabat, Morocco
| | - Chaymae Faraj
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina, Hospital, Mohamed V University, Rabat, Morocco
| | - Ihssane Lahlou
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina, Hospital, Mohamed V University, Rabat, Morocco
| | - Fatima Chait
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina, Hospital, Mohamed V University, Rabat, Morocco
| | - Nourrelhouda Bahlouli
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina, Hospital, Mohamed V University, Rabat, Morocco
| | - Nazik Allali
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina, Hospital, Mohamed V University, Rabat, Morocco
| | - Siham El Haddad
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina, Hospital, Mohamed V University, Rabat, Morocco
| | - Latifa Chat
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina, Hospital, Mohamed V University, Rabat, Morocco
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Messaoudi H, Benlghazi A, Elktaibi A, Belouad M, Moulay Mehdi E, Kouach J. A challenging diagnosis and treatment of embryonal rhabdomyosarcoma in the cervix of an adult woman: A surgical case report. Int J Surg Case Rep 2024; 119:109742. [PMID: 38759402 PMCID: PMC11127508 DOI: 10.1016/j.ijscr.2024.109742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 05/19/2024] Open
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.
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Affiliation(s)
- Hamza Messaoudi
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V, Rabat, Morocco
| | - Abdelhamid Benlghazi
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V, Rabat, Morocco.
| | - Abderrahim Elktaibi
- Department of Pathology Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V, Rabat, Morocco
| | - Moad Belouad
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V, Rabat, Morocco
| | - Elhassani Moulay Mehdi
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V, Rabat, Morocco
| | - Jaouad Kouach
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V, Rabat, Morocco
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Etrusco A, Agrifoglio V, Laganà AS, Gliozheni E, Caringella A, Stanziano A, Cicinelli E, Chiantera V, Giannini A, Alsannan B, Barra F, D’Amato A. Reproductive and oncologic outcomes in young women with uterine sarcoma undergoing fertility-sparing treatment: a systematic review. Ther Adv Reprod Health 2024; 18:26334941241271563. [PMID: 39351375 PMCID: PMC11440568 DOI: 10.1177/26334941241271563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 07/04/2024] [Indexed: 10/04/2024] Open
Abstract
Background Uterine sarcomas (US) are rare cancer of possible occurrence even in women of childbearing age. To date, total hysterectomy is the standard treatment in the early stages. The possibilities of carrying out fertility-sparing treatments (FST) to save the fertility of women with unfulfilled reproductive desires are described in the literature, but to date, they can only be considered experimental. Objective The aim of this systematic review was to evaluate the oncological and reproductive outcomes of women with different histological types of US undergoing FST. Design Systematic review. Data sources and methods Electronic databases were searched for English-language studies describing FST for US until January 31, 2024. Results Forty-five papers which met the abovementioned inclusion criteria, were included in the qualitative analysis. Quantitative analysis was not possible because of the heterogeneity of the data. A descriptive summary of the results according to the histotype of US was provided. Six hundred forty-one patients of childbearing age with US and undergoing FST. After treatment with FST, 89 (13.9%) disease recurrences and 107 (16.7%) pregnancies were recorded. Conclusion In selected cases of early-stage US, FST may be proposed. However, the patient must be informed of the real possibility of recurrence and potentially difficult achievement of pregnancy. Additional well-designed prospective studies and clinical trials are needed to address the knowledge gaps and enhance clinical decision-making in this population. Trial registration PROSPERO ID: CRD42024509356.
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Affiliation(s)
- Andrea Etrusco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza Marina, 61, Palermo 90133, Italy
- Unit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Palermo, Italy
| | - Vittorio Agrifoglio
- Unit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Antonio Simone Laganà
- Unit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Elko Gliozheni
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
- Department of Obstetrics and Gynecology, University of Medicine of Tirana, Tirana, Albania
| | - Annamaria Caringella
- Department of Advanced Reproductive Risk Management and High-Risk Pregnancies, ASL Bari, Reproductive and IVF Unit, PTA Conversano, Conversano, Italy
| | - Antonio Stanziano
- Department of Advanced Reproductive Risk Management and High-Risk Pregnancies, ASL Bari, Reproductive and IVF Unit, PTA Conversano, Conversano, Italy
| | - Ettore Cicinelli
- Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Vito Chiantera
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
- Unit of Gynecologic Oncology, National Cancer Institute—IRCCS—Fondazione “G. Pascale,” Naples, Italy
| | - Andrea Giannini
- Unit of Gynecology, Department of Surgical and Medical Sciences and Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Baydaa Alsannan
- Department of Obstetrics and Gynecology, College of Medicine, Kuwait University, Safat, Kuwait
| | - Fabio Barra
- Unit of Obstetrics and Gynecology, P.O. “Ospedale del Tigullio”—ASL4, Chiavari, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Antonio D’Amato
- Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
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Ramachandran A, Maroli R, Narayanan P, Kovilakam SN, Padikkathodika AA, Joseph CP, Puthiyapurayil SMK, Guhan B. Adolescent Embryonal Rhabdomyosarcoma of the Uterus–A Case report and Systematic Review. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2023. [DOI: 10.1007/s40944-022-00697-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Piątek S, Szymusik I, Dańska-Bidzińska A, Ołtarzewski M, Trojan G, Bidziński M. Fertility-Sparing Management May Be Considered in Young Women with Uterine Sarcoma. J Clin Med 2022; 11:jcm11164761. [PMID: 36012998 PMCID: PMC9410102 DOI: 10.3390/jcm11164761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022] Open
Abstract
Uterine sarcomas occur very rarely in young women. Hysterectomy, which is a standard treatment, may not be acceptable for those patients, especially nulliparous women. Fertility-sparing management may be an alternative. The aim of the study was to assess fertility-sparing management in patients with uterine sarcoma. Eleven patients were eligible for the study. Histopathologic types of the tumor included: adenosarcoma (n = 3), low-grade endometrial stromal sarcoma (n = 3), low-grade myofibroblastic sarcoma (n = 1), leiomyosarcoma (n = 1), leiomyosarcoma myxoides (n = 1), rhabdomyosarcoma (n = 1), high grade endometrial stromal sarcoma (n = 1). The mean age of the patients at the time of diagnosis was 27.4 years (range: 17–35) and the average follow-up 61 months (range: 12–158). Six patients received adjuvant treatment: megestrol (n = 5) and chemotherapy (n = 1). Recurrence was diagnosed in five cases. Median time to recurrence was 35 months (range: 8–90). Three patients conceived spontaneously following treatment and gave at least one live birth. In total, five full-term pregnancies were recorded and five healthy children were born. Fertility-sparing management may be considered in some patients with uterine sarcoma; however, it may not be appropriate in high-grade endometrial stromal sarcoma. Patients with adenosarcoma may have a low chance of childbearing.
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Affiliation(s)
- Szymon Piątek
- Department of Gynecologic Oncology, the Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Street, 02-781 Warsaw, Poland
- Correspondence:
| | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland
| | - Anna Dańska-Bidzińska
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | | | - Gabriela Trojan
- Students’ Scientific Group, Kazimierz Pulaski University of Technology and Humanities in Radom, 26-600 Radom, Poland
| | - Mariusz Bidziński
- Department of Gynecologic Oncology, the Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Street, 02-781 Warsaw, Poland
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Uterine Preservation Treatments in Sarcomas: Oncological Problems and Reproductive Results: A Systematic Review. Cancers (Basel) 2021; 13:cancers13225808. [PMID: 34830960 PMCID: PMC8616470 DOI: 10.3390/cancers13225808] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/09/2021] [Accepted: 11/17/2021] [Indexed: 12/29/2022] Open
Abstract
Uterine sarcomas are rare cancers, sometimes diagnosed in women of childbearing age. Hysterectomy is the standard treatment in early stages. The option of lesion removal to save fertility is described in the literature, but it is still considered experimental. The objective of this systematic review is to report on the available evidence on the reproductive and oncological outcomes of fertility-sparing treatment in women with uterine sarcomas. PubMed, Scopus and Cochrane Central Register of Controlled Trials were searched between 1 January 2011 and 21 June 2021 for publications in English about women with uterine sarcoma treated with a fertility-sparing intervention. Thirty-seven studies were included for a total of 210 patients: 63 low-grade endometrial stromal sarcomas, 35 embryonal rhabdomyosarcomas of the cervix, 19 adenosarcomas, 7 leiomyosarcomas and 2 uterine tumors resembling an ovarian sex cord. Conservative treatment ensured pregnancy in 32% of cases. In terms of oncological outcomes, relapse was related to histology and the worst prognosis was reported for leiomyosarcoma, followed by low-grade endometrial stromal sarcoma, which relapsed in 71% and 54% of cases, respectively. The highest death rate was associated with leiomyosarcoma (57.1%). This study demonstrated that fertility-sparing treatments may be employed in selected cases of early stage uterine sarcoma.
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ALSaleh N, ALwadie H, Gari A. Rhabdomyosarcoma of the genital tract in an 18-month-old girl. J Surg Case Rep 2017; 2017:rjx080. [PMID: 28469838 PMCID: PMC5406612 DOI: 10.1093/jscr/rjx080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 04/12/2017] [Indexed: 11/15/2022] Open
Abstract
Embryonal Rhabdomyosarcoma 'Botryoid Type' is a rare soft tissue tumor that arises within the wall of the bladder or vagina and seen almost exclusively in infants. Treatment is combination of surgery with adjuvants chemotherapy and radiotherapy. We report a case of an 18-month-old Saudi girl presented with history of abdo-pelvic mass, bleeding per vagina and a mass protruding through the introitus. Computed tomography (CT) done reveling large heterogeneous pelvic mass arising from the uterus, biopsy of mass confirmed the diagnosis (sarcomabotryoidal). The patient received multiple cycles of combination chemotherapy as a neoadjuvant treatment then underwent total abdominal hysterectomy with upper vaginectomy. Postoperatively, the patient received more cycles of chemotherapy. CT scan for post-treatment evaluation was done and showed no evidence of local recurrence or distant metastasis. Currently, she is disease-free on remission with no complains.
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Affiliation(s)
- Nourah ALSaleh
- Bachelor degree of medicine and general surgery (MBBS), Umm Al-Qura University, Makkah, Saudi Arabia
- Correspondence address. Umm Al-Qura University, P.O. Box: 7633, Makkah 21955, Saudi Arabia. Tel: +966-563590060; E-mail:
| | - Hadeel ALwadie
- Medical Intern, King Khalid University, Abha, Saudi Arabia
| | - Abdulrahim Gari
- King Faisal Specialist Hospital and Research Center, Dep. of obstetrics & Gynecology, Jeddah, Saudi Arabia
- College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
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