The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Embryonal rhabdomyosarcoma of the cervix in a 57-year-old woman: a case report of diagnostic and therapeutic trends

Document Type : Case report

Authors
Mahsa Akbari Oryani 1
Sahar Seifnia 2
Marjaneh Farazestanian 3
Nastaran Saljoughi 2
1 Assistant Professor, Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Resident, Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
10.22038/ijogi.2025.83540.6241
Abstract
Introduction: Embryonic rhabdomyosarcoma (ERMS) of the cervix is ​​a type of soft tissue sarcoma that usually occurs in young women and is very rare in adulthood. In this study, a case of embryonal rhabdomyosarcoma of the cervix in a 57-year-old woman was reported.
Case presentation: The patient was a 57-year-old woman with symptoms of a palpable mass at the external cervical os and postmenopausal bleeding who was admitted to Omid Hospital, and the lesion was excised. Histopathological examination showed proliferation of small round cells in some cases with a rhabdoid appearance. Accordingly, the initial diagnosis of embryonal rhabdomyosarcoma was made. This diagnosis was confirmed by immunohistochemistry and myogenin positivity, and the patient underwent total hysterectomy and bilateral salpingo-oophorectomy. The tumor was confined to the cervix and there was no evidence of metastasis in additional examinations. In the 26-month follow-up of the patient, there was no sign of recurrence or symptoms related to embryonal rhabdomyosarcoma.
Conclusion: Given the rarity of embryonal rhabdomyosarcoma in postmenopausal women, this tumor may not be diagnosed by histopathology alone and immunohistochemical examination is required for relevant markers. Therefore, when observing a polypoid lesion in the cervix at any age, diagnosing embryonal rhabdomyosarcoma should also be considered. Timely diagnosis and treatment of the disease can prevent tumor recurrence in patient.
Keywords
Cervix
Immunohistochemistry
Neoplasm recurrence
Postmenopause
Rhabdomyosarcoma embryonal
Subjects
  1. Morotti RA, Nicol KK, Parham DM, Teot LA, Moore J, Hayes J, et al. An immunohistochemical algorithm to facilitate diagnosis and subtyping of rhabdomyosarcoma: the Children's Oncology Group experience. The American journal of surgical pathology 2006; 30(8):962-8.
  2. Santos P, Cunha TM. Uterine sarcomas: clinical presentation and MRI features. Diagnostic and Interventional Radiology 2014; 21(1):4.
  3. Dasgupta R, Fuchs J, Rodeberg D. Rhabdomyosarcoma. Semin Pediatr Surg 2016; 25(5):276-283.
  4. Pawlik J, Pawlik W, Branecka-Woźniak D, Kotrych K, Cymbaluk-Płoska A. Rhabdomyosarcoma of the cervix in a post-menopausal woman—an unparalleled phenomenon. International Journal of Environmental Research and Public Health 2021; 18(15):7851.
  5. Ricciardi E, Plett H, Sangiorgio V, Paderno M, Landoni F, Aletti G, et al. Adult primary cervical rhabdomyosarcomas: A Multicentric cross-national case series. International Journal of Gynecologic Cancer 2020; 30(1).
  6. Wei X, Li L. Cytological diagnosis of patients with embryonal rhabdomyosarcoma of the cervix: case report and literature review. Diagnostic Pathology 2024; 19(1):73.
  7. Karimkhani S, Mirzaie M, Sarmadi S, Kolangdari Z. BOTRROID Embryonal Rhabdomyosarcoma with Uterine Cervix in a Postmenopausal Woman: An Unusual Case Report. Journal of Mid-life Health 2024; 15(1):32-5.
  8. Paturi B, Doddapaneni P, Guruvare S, Usman N, Udupa K. A Rare Case of Adult Embryonal Rhabdomyosarcoma of the Uterus in a Postmenopausal Woman. Indian Journal of Surgical Oncology 2024: 1-4.
  9. Messaoudi H, Benlghazi A, Elktaibi A, Belouad M, Mehdi EM, Kouach J. A challenging diagnosis and treatment of embryonal rhabdomyosarcoma in the cervix of an adult woman: A surgical case report. International Journal of Surgery Case Reports 2024; 119:109742.
  10. Jadhav T, Madakshira MG, Garud S. Embryonal rhabdomyosarcoma of the uterine cervix in an adult female. Autopsy and Case Reports 2023; 13:e2023419.
  11. Ibrahim U, Saqib A, Mohammad F, Ding J, Salman B, Collado FK, et al. Embryonal rhabdomyosarcoma of the cervix: a rare disease at an uncommon age. Cureus 2017; 9(11).
  12. Nasioudis D, Alevizakos M, Chapman-Davis E, Witkin SS, Holcomb K. Rhabdomyosarcoma of the lower female genital tract: an analysis of 144 cases. Archives of gynecology and obstetrics 2017; 296:327-34.
  13. Buruiana FE, Gupta B, Singh K. Rhabdomyosarcoma of the cervix in teenagers–Is fertility preservation a feasible option?. Gynecologic Oncology Reports 2020; 34:100677.
  14. Pop FC, Pop CS, Moreau M, Jungels C, Chintinne M, Artigas GC, et al. P107 Embryonal rhabdomyosarcoma of uterus in adult women: a systematic review and survival analysis of 116 patients. International Journal of Gynecologic Cancer 2019; 29(Suppl 4).
  15. Kobayashi H, Okajima K, Zhang L, Hirai T, Ishibashi Y, Tsuda Y, et al. Embryonal and alveolar rhabdomyosarcoma in adolescents/young adults, adults and older adults: a population-based cohort study. Japanese Journal of Clinical Oncology 2024: hyae053.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 27, Issue 11
January 2025
Pages 88-93