A rare case of cervical Rhabdomyosarcoma in an Adolescent- A case report

Authors

  • Leek Mei Lim Birmingham Women's and Children's NHS Foundation Trust
  • Suguna Subramaniam Gynaeoncology Unit, Department of Obstetrics & Gynaecology, Sabah Women and Children’s Hospital, Kota Kinabalu, Sabah, Malaysia
  • Tamilarasi Renganathan Anatomic Pathology, Department of Pathology, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia
  • Ana Vetriana Abd Wahab Sabah Care Fertility Centre

DOI:

https://doi.org/10.17576/JSA.2024.1402.04

Keywords:

Cervical Embryonal Rhabdomyosarcoma, ERMS, adolescent polyp, Paediatrics and adolescent gynecology, PAG, Fertility sparing surgery, case report

Abstract

We present a rare case of cervical embryonic rhabdomyosarcoma (ERMS) in adolescents, managed with fertility-sparing surgery and chemotherapy. This type of malignant tumour is rare, and the management is not codified. A 15-year-old girl presented with a tongue-like mass per vagina and abnormal discharge. She underwent vaginoscopy under anaesthesia, which revealed a polyp from the endocervix. Hysteroscopic resection was performed, and histopathology showed ERMS. Postoperative imaging suggests the presence of residual local disease without evidence of distant metastasis. A multidisciplinary team (MDT) meeting was conducted, and the family opted for fertility-sparing management. The patient underwent repeat hysteroscopy-guided local excision, followed by eight cycles of chemotherapy, with close surveillance. In conclusion, polyps are rather odd in adolescents; malignancy should always be suspected. Fertility-sparing surgery with chemotherapy is a plausible option in well-selected cases.

Author Biographies

Leek Mei Lim, Birmingham Women's and Children's NHS Foundation Trust

Clinical fellowPaediatrics and Adolescent Gynaecology (PAG)Birmingham Women's Hospital

Suguna Subramaniam, Gynaeoncology Unit, Department of Obstetrics & Gynaecology, Sabah Women and Children’s Hospital, Kota Kinabalu, Sabah, Malaysia

consultant Gynaeoncology

Tamilarasi Renganathan, Anatomic Pathology, Department of Pathology, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia

Pathologist

Ana Vetriana Abd Wahab, Sabah Care Fertility Centre

Reproductive medicine specialist, Paediatrics and Adolescent Gynaecologist, Consultant obstetrics and gynaecology

References

Jayi S, Bouguern H, Fdili FZ, et al. Embryonal rhabdomyosarcoma of the cervix presenting as a cervical polyp in a 16-year-old adolescent: A case report. J Med Case Rep 2014; 8(1): 241.

Bell SG, Konney TO, Appiah-Kubi, et al. Two rare presentations of embryonal rhabdomyosarcoma of the cervix in teenagers at a low-resource teaching hospital in Ghana: A case series. Gynecol Oncol Rep 2021; 36: 100750.

Buruiana FE, Gupta B, Singh K. Rhabdomyosarcoma of the cervix in teenagers - Is fertility preservation a feasible option? Gynecol Oncol Rep 2020; 34: 100677.

Kriseman ML, Wang WL, Sullinger J, et al. Rhabdomyosarcoma of the cervix in adult women and younger patients. Gynecol Oncol 2012; 126(3): 351-6.

Jo VY, Fletcher CD. WHO classification of soft tissue tumours: An update based on the 2013 (4th) edition. Pathology 2014; 46(2): 95-104.

Villella JA, Bogner PN, Jani-Sait SN, Block AM, Lele S. Rhabdomyosarcoma of the cervix in sisters with review of the literature. Gynecol Oncol 2005; 99(3): 742-8.

Dondi G, Porcu E, De Palma A, et al. Uterine preservation treatments in sarcomas: Oncological problems and reproductive results: A systematic review. Cancers (Basel). 2021; 13(22): 5808.

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Published

2024-12-10

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Articles