Table of Contents
Definition / general | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Positive stains | Differential diagnosisCite this page: Perunovic B. Rhabdomyosarcoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixrhabdomyosarcoma.html. Accessed February 27th, 2021.
Definition / general
- Rhabdomyosarcomas are divided into embryonal, botryoid (subtype of embryonal), alveolar or pleomorphic (anaplastic) subtypes
- Embryonal type is most common; occurs in children; more common in vagina than cervix
- Cases in older women often contain cartilage and have better prognosis
Case reports
Embryonal rhabdomyosarcoma:
Other types:
- 13 year old girl with anaplastic (pleomorphic) subtype (Arch Gynecol Obstet 2004;270:278)
- 17 year old girl with botryoid subtype and recurrence after excision and chemotherapy (Acta Cytol 1999;43:475)
- 19 year old with tumor in cervical polyp (Gynecol Oncol 2004;95:243)
- 46 year old woman with botryoid subtype (Int J Gynecol Pathol 2004;23:78)
- Patients with pediatric heterologous tumors (Gynecol Oncol 2005;99:742)
Other types:
- 39 year old woman with alveolar rhabdomyosarcoma (Gynecol Oncol 2003;91:623)
Treatment
- Minor surgery plus chemotherapy may be recommended for stage I disease (Eur J Pediatr 2004;163:452)
Gross description
- Botryoid cases have protrusion of grape-like masses (due to edema and myxoid stroma) from cervix into vagina
- Surface is glistening and translucent
Microscopic (histologic) description
- Botryoid - polypoid mass of rhabdomyoblasts at different maturational stages covered by attenuated epithelium; resembles vaginal tumor; often cambium layer beneath cervical epithelium in botryoid cases; often loose myxoid stroma, surface ulceration; may have cartilage in older women; variable mitotic rate
- In young children, tumor cells may lack marked atypia and may blend in with normal, immature, cellular stroma
Cytology description
- Loose clusters of spindled cells in a necrotic background; cells have mild nuclear atypia, thin nuclear membrane, fine chromatin pattern, partly clear nucleolus
Positive stains
- In young children, focal staining for desmin, muscle specific actin, smooth muscle actin, MyoD1 and WT1, although not specific (Pediatr Dev Pathol 2005;8:427)
Differential diagnosis
- Adenosarcoma: fibrous stroma so no grape-like clusters, no edematous, leaf-like pattern resembling phyllodes tumor
- Edematous mesodermal polyp: adult women, small, soft fleshy protuberances up to 1.5 cm, stroma is uniform, no cambium layer, no rhabdomyoblasts, may have widely scattered atypical stromal cells
- Yolk sac tumor