A Rare Report of Vaginal Rhabdomyosarcoma

Abstract

Sarcomas are connective tissue cancers and Rhabdomyosarcomas are cancers originating from the skeletal muscle cells of the body. A 23 year old female unmarried, nulligravida presented in our emergency with the complaint of bleeding per vagina on and off since last 4 months. The lesion measured 9.2 (cc) x8.7 (cs)x7.8 (ap) cm. The lesion displaced the uterus superiorly distended the vaginal canal compressed the urinary bladder and urethra anteriorly but with no evidence of infiltration into the pelvic side wall and with maintained fat plane. Rest all pelvic organs as well as abdominal organs were within normal limit. The HPE report on microscopic examination of the tissue showed features suggestive of malignant spindle cell neoplasm. Immunohistochemistry was done and IHC report showed: Positive for Desmin, Myogenin predominantly cytoplasmic positive. Correlating the morphologic and IHC markers the report came to be Embryonal Rhabdomyosarcoma (Botryoid Rhabdomyosarcoma). As soon as the final diagnosis was made patient was referred to Department of Oncology and chemotherapy with Cyclophosphamide was started. She has been on regular follow up since then and is keeping well. The presence of a cervical polyp in an adolescent is a gynecologic oddity and must necessarily be examined histologically because it might be a rhabdomyosarcoma. This is extremely important because diagnosis at an early stage of the disease is a highly favorable prognostic factor.