1: Gynecol Oncol. 2004 Oct;95(1):243-6.
Embryonal rhabdomyosarcoma (sarcoma botryoides) of the cervix presenting as a cervical polyp treated with fertility-sparing surgery and adjuvant chemotherapy.
Bernal KL, Fahmy L, Remmenga S, Bridge J, Baker J.
Department of Pathology/Microbiology, University of Nebraska Medical Center, Omaha, Nebraska 58198, USA. kbernal@unmc.edu
BACKGROUND: Embryonal rhabdomyosarcoma (sarcoma botryoides) of the female genital tract is rare in the cervix. It tends to occur in children and young women, and appears to have a better prognosis than sarcoma botryoides of the vagina and uterus. CASE: We report a case of embryonal rhabdomyosarcoma (sarcoma botryoides) presenting as a cervical polyp in a 19-year-old female. The tumor was composed of rhabdomyoblasts of varying differentiation dispersed within a loose, myxoid stroma, and formed a distinct 'cambium' layer beneath the epithelium. The patient was successfully treated with fertility-sparing surgery and adjuvant chemotherapy. CONCLUSIONS: Awareness of this uncommon lesion in this site and its clinical implications is important to avoid misdiagnosis. Therapy has recently inclined towards conservative treatment.
2: Int J Gynecol Pathol. 2004 Jan;23(1):78-82.
Sarcoma botryoides of the uterine cervix in a 46-year-old woman: case report and literature review.
Miyamoto T, Shiozawa T, Nakamura T, Konishi I.
Department of Obstetrics and Gynecology, Shinshu University School of Medicine, Asahi, Matsumoto , Japan .
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.
3: Gynecol Oncol. 2003 Nov;91(2):452-5.
Embryonal rhabdomyosarcoma of the uterine cervix: case report and review of the literature.
Behtash N, Mousavi A, Tehranian A, Khanafshar N, Hanjani P.
Gynecology Oncology Department, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran 14194, Iran. valrec2@yahoo.com
OBJECTIVES: Sarcoma botryoides rarely arises in the uterine cervix. It usually presents in the adolescent age group. The peak incidence is in the second decade. A combined modality approach to treating rhabdomyosarcoma (RMS) has markedly improved survival. We present two cases of cervical RMS. One of them had a very aggressive clinical course. CASE: Two cases of RMS in young women who presented with rapidly progressive cervical tumor are reported. They were treated with two-stage surgical procedure and chemotherapy. CONCLUSIONS: A combined modality approach to treating RMS using multidrug chemotherapy, radiotherapy, and surgery has markedly improved survival. One of our cases has been free of disease for more than 5 years.
3: Eur J Gynaecol Oncol. 2000;21(5):504-6.
Sarcoma botryoides of the uterine cervix in a young woman: a case report.
Atlante M, Dionisi B, Cioni M, Di Ruzza D, Sedati P, Mariani L.
Gynecologic Oncology Dept., Regina Elena National Cancer Institute, Rome, Italy.
Among the rhabdomyosarcomas, which represent an uncommon neoplasm of mesoderm origin comprising about 1% of all female genital malignancies, sarcoma botryoides (SB) is an embryonal variant usually found in the vagina of infants and young children under 16 years of age. The onset of SB from the uterine cervix is very rare with a peak incidence in the second decade; only a few cases have been published in the international literature so far. The authors report a case of embryonal rhabdomyosarcoma of the uterine cervix which occurred in a young woman treated by radical surgery, followed by adjuvant chemotherapy and radiotherapy.
4: Cancer Radiother. 2002 Dec;6(6):363-5.
Sarcoma botryoide of the uterine cervix: report of a case
Saadi I, Errihani H, Haddadi K, Amaoui B, Benjaafar B, El Gueddari BK.
Service de radiotherapie, institut national d'oncologie, BP 6213 RI, Rabat, Maroc. imanesaadi@hotmail.com
Botryoide sarcoma of the uterine cervix is a very rare tumor of the young woman or during genial activity. Less than 100 cases have been reported in the literature. The treatment ranged from radical surgery to conservative surgery followed by chemotherapy. We report a case of cervical botryoide rhabdomyosarcoma occurred in a 33 year-old woman treated primary by chemotherapy followed by surgery and adjuvant chemotherapy. The patient died by extensive metastatic retroperitoneal nodes and lung.
5: Gynecol Obstet Fertil. 2002 Oct;30(10):784-6.
Botryoide sarcoma of the uterine cervix. Apropos of 1 case
Zrara I, Mounzil CD, Rimani M, Bouzidi A, Labraimi A, Ben Omar C.
Service d'anatomie pathologique, Hopital militaire d'instruction Mohamed V, Rabat , Maroc.
Sarcoma botryoide (SB), a variant of rhabdomyosarcoma, is a rare tumor who are rarely localized in the uterine cervix. Only 99 cases have been described to date. The authors reported this case with review of the literature in order to insist on diagnosis progress and a new combined modality approach using: radiotherapy, surgery and chemotherapy which have improved prognosis in the localized disease especially.
6: Eur J Gynaecol Oncol. 2000;21(5):504-6.
Sarcoma botryoides of the uterine cervix in a young woman: a case report.
Atlante M, Dionisi B, Cioni M, Di Ruzza D, Sedati P, Mariani L.
Gynecologic Oncology Dept., Regina Elena National Cancer Institute, Rome , Italy .
Among the rhabdomyosarcomas, which represent an uncommon neoplasm of mesoderm origin comprising about 1% of all female genital malignancies, sarcoma botryoides (SB) is an embrional variant usually found in the vagina of infants and young children under 16 years of age. The onset of SB from the uterine cervix is very rare with a peak incidence in the second decade; only a few cases have been published in the international literature so far. The authors report a case of embryonal rhabdomyosarcoma of the uterine cervix which occurred in a young woman treated by radical surgery, followed by adjuvant chemotherapy and radiotherapy.
7: J Reprod Med. 1999 Mar;44(3):306-8.
Cervical sarcoma botryoides. A case report.
Vlahos NP, Matthews R, Veridiano NP.
Department of Gynecology and Obstetrics, Johns Hopkins Hospital , Baltimore , Maryland 21287-1247 , USA .
BACKGROUND: Sarcoma botryoides is a rare gynecologic malignancy. Reported treatment protocols range from localized resection of the tumor to radical surgery and adjuvant chemotherapy. Recently, limited excisional surgery combined with chemotherapy has contributed to excellent survival rates and preserved bladder and rectal function. CASE: We report a case of cervical sarcoma botryoides with minimal invasion. The patient had primary surgical treatment with complete resection of the tumor without adjuvant chemotherapy. Four months after surgery she presented with extensive metastatic retroperitoneal disease and died two weeks later. CONCLUSION: The clinical course of this patient suggests that complete surgical resection in cases of localized disease is not adequate therapy for sarcoma botryoides. Adjuvant chemotherapy should always be used, even at a very early stage.
8: Geburtshilfe Frauenheilkd. 1996 Aug;56(8):441-2.
[Sarcoma botryoides in the pediatric vagina--a soft tissue sarcoma with good prognosis]
Wierrani F, Zoubek A, Grin W, Kronberger M, Preiser J, Gabriel C, Bibus B, Koscielniak E, Gadner H, Grunberger W.
Gynakologische & Geburtshilfliche Abteilung, Krankenanstalt Rudolfstiftung, Wier.
Although rare, sarcoma botryoides of the vagina in infants is a highly aggressive soft tissue tumour. Former opinions suggesting exenterative surgery and radiation to improve the dismal outcome in these young children, are outdated. Due to balanced therapies (topical tumourectomy, chemotherapy and radiation adjusted to tumour stage) cure of these sarcomas may be expected dependent on tumour stage, localisation and response to chemotherapy. The rate of complete remissions has increased in recent years. We report on an eighteen-month old girl with complete remission of tumour stage IIA who had been treated according to the CWS 91 protocol. Diagnosis and treatment were performed in March 1994 at the age of six months. We observed the patient in complete remission for 8 months (till September 1995).
9: Gynecol Oncol. 1988 Mar;29(3):290-304.
Sarcoma botryoides of the uterine cervix in young women: a clinicopathological study of 13 cases.
Daya DA, Scully RE.
Department of Pathology, Henderson General Hospital, Hamilton, Ontario, Canada.
Although the clinical and pathological features of sarcoma botryoides of the vagina in infancy are well documented in the literature, only occasional cases of a histologically similar tumor of the uterine cervix have been described, mostly as individual case reports. We have reviewed 13 cases of sarcoma botryoides of the cervix. The patients range in age from 12 to 26 years, with a mean of 18 years. All presented with vaginal bleeding, "something" protruding from the introitus, or both. On gross examination the tumors were polypoid, smooth, glistening, and focally hemorrhagic. Microscopic examination revealed the presence of a cambium layer and cells showing the features of rhabdomyoblasts in all the cases. Six of the 13 tumors (45%) contained foci of mature cartilage. All the patients were alive and well 1 to 8 years (average 3.5 years) postoperatively except for one who died of the tumor after 1 year. Although most of the patients had a radical operation, sometimes followed by chemotherapy, three had excellent results after polypectomy or cervicectomy. The findings indicate that, unlike its counterpart in the vagina, which has a poor prognosis, sarcoma botryoides of the cervix in young women has a favorable outlook.
