Cervical embryonal rhabdomyosarcoma beyond childhood: A case report and literature review

TL;DR

This paper reports a rare case of cervical embryonal rhabdomyosarcoma in an adult woman and emphasizes the importance of early diagnosis and multidisciplinary treatment.

Contribution

The novelty lies in presenting a rare case of cervical embryonal rhabdomyosarcoma in an adult, expanding awareness beyond typical pediatric presentations.

Findings

ERMS in adults can present with symptoms like urinary retention and vaginal bleeding.

Histopathology and immunohistochemistry confirmed ERMS with desmin, myogenin, and MyoD1 positivity.

Multidisciplinary treatment is essential for managing cervical ERMS in adults.

Abstract

Embryonal rhabdomyosarcoma (ERMS) arising from the uterine cervix is a rare malignancy, predominantly affecting children and adolescents. This case report highlights a rare presentation of cervical ERMS in an adult woman, emphasizing the importance of considering ERMS in the differential diagnosis of a cervical mass in adult women and highlights the critical role of a multidisciplinary treatment approach. A 31-year-old woman presented with acute urinary retention, vaginal bleeding, and postcoital bleeding. Imaging at presentation revealed a large cervical mass exerting a significant mass effect on adjacent structures. Histopathology of the surgically excised mass confirmed the diagnosis of ERMS, with tumor cells arranged in sheets of small, round cells with scant eosinophilic cytoplasm and eccentric, small oval nuclei and inconspicuous nucleoli, supported by immunohistochemical staining positive for desmin, myogenin, and MyoD1. The patient underwent surgical resection; however, she was lost to follow-up, limiting long-term outcome assessment. Cervical ERMS is an aggressive soft tissue sarcoma that rarely occurs in adult women. It can mimic other cervical pathologies, posing diagnostic challenges. Ultrasound and magnetic resonance imaging are key for initial assessment, while early diagnosis, surgery, and adjuvant chemotherapy improve outcomes. Optimal management requires a multidisciplinary team.

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