Published: 2019-04-29

Recurrent vaginal discharge: an unusual presentation of embryonal rhabdomyosarcoma of uterine cervix in an adolescent girl

Divya Sarin, Urmila Singh, Seema Mehrotra, Vandana Solanki


Embryonal rhabdomyosarcoma (ERMS) is a rare tumor of the female genital tract. It tends to occur during childhood in the vagina and rarely it can arise in the uterine cervix, with a peak incidence in the second decade. We report a case of 15 year old adolescent girl who presented with recurrent vaginal discharge not responding to medical treatment. Examination under anesthesia showed friable growth arising from the cervix. Histopathological examination revealed embryonal rhabdomyosarcoma (botyroid variant) of the cervix. Patient underwent local excision of growth followed by IRS-4 protocol based chemotherapy and now patient is under follow up at our side and pediatric oncology and doing well. Young girls presenting with recurrent vaginal discharge not responding to medical treatment must undergo proper clinical examination and EUA and any suspicious lesions should be examined so as to avoid missing rare but aggressive etiology like rhabdomyosarcoma. Due to the young age of affected patients, embryonal rhabdomyosarcoma (sarcoma botyroides) poses a management challenge as the preservation of hormonal, sexual and reproductive function is essential. Awareness of such as uncommon lesion and its clinical implications is important for the counseling and management of the patient.


Embryonal rhabdomyosarcoma, IRS-4 protocol, Sarcoma botyroides, Uterine cervix neoplasm

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Gomes AR, Leite PB, Rocha JS, Enes PV, Carvalho JI, Pinto AR, et al. Embryonal rhabdomyosarcoma of the uterine cervix: a rare case report. Int J Reprod Contracept Obstet Gynecol. 2017;6:309-12.

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

Raney RB, Maurer HM, Anderson JR. The Intergroup Rhabdomyosarcoma Study Group (IRSG): Major Lessons From the IRS-I Through IRS-IV Studies as Background for the Current IRS-V Treatment Protocols. Sarcoma. 2001;5(1):9-15.

Behtash N, Mousavi A, Tehranian A, Khanafshar N, Hanjani P. Embryonal rhabdomyosarcoma of the uterine cervix: case report and review of the literature. Gynecol Oncol. 2003;91:452-5.

Dehner LP, Jarzembowski JA, Hill DA. Embryonal rhabdomyosarcoma of the uterine cervix: a report of 14 cases and a discussion of its unusual clinicopathological associations. Mod Pathol. 2012;25(4):602-14.

Bernal KL, Fahmy L, Remmenga S, Julia B, Baker J. Embryonal rhabdomyosarcoma (sarcoma botryoides) of the cervix presenting as a cervical polyp treated with fertility-sparing surgery and adjuvant chemotherapy. Gynecol Oncol. 2004;95:243-6.

Melo A, Amorim-Costa C, Pires MC, Fernandes D, Soares M, Cambão M, et al. Botryoid rhabdomyosarcoma of the uterine cervix: a case report. Journal Obstet and Gynaecol. 2012;7:709-11.

Bouchard-Fortier G, Kim RH, Allen L, Gupta A, May T. Fertility-sparing surgery for the management of young women with embryonal rhabdomyosarcoma of the cervix: A case series. Gynecol Oncol Rep. 2016;18:4-7.

Ayas S, Uygur L, Bostanci E, Gürbüz A. A successful pregnancy during the treatment of cervical sarcoma botryoides and advantage of fertility sparing management: A case report: Iran J Reprod Med. 2015;13(2):113-6.