SARCOMA BOTRYOIDES (EMBRYONAL RHABDOMYOSARCOMA ) – CERVIX

SARCOMA BOTRYOIDES (EMBRYONAL RHABDOMYOSARCOMA ) – CERVIX

Embryonal rhabdomyosarcoma is characterized by grape like clusters and an edematous myxoid background  containing rhabdomyoblasts.

Age – common in younger women (but can occur in age group)

Clinical presentation – vaginal bleeding or mass protruding from introitus

Gross – polypoidal mass with glistening translucent surface. Cut section is gray-white with myxoid areas and areas of hemorrhage

Microscopy 

  • Tumor is covered by layer of squamous epithelium, beneath which dense cellular zone (cambium layer) containing small round,  plump and spindle shaped cells, with hyperchromatic nuclei and scant cytoplasm will be present
  • Beneath cambium layer are sparsely cellular myxomatous stroma with dispersed rhabdomyoblasts
  • Tumor cells are condensed around endocervical glands
  • .Islands of hyaline cartilage are noted
Immunohistochemistry
Desmin, myoglobin and Muscle specific actin are positive
Prognosis is more favourable in most cases with an 80% survival in patients with cervical tumor
  • The main adverse pathologic prognostic factor is deep invasion
  • Tumors with foci resembling alveolar rhabdomyosarcoma may be more aggressive.
Tumor lined by squamous epithelium beneath which dense cellular zone (cambium layer) containing small round, plump, spindle cells with hyperchromatic nuclei. Tumor cells are condensed around endocervical glands (H&E,X50)

Embryonal Rhabdomyosarcoma :Tumor lined by squamous epithelium beneath which is dense cellular zone (cambium layer) containing small round, plump, spindle cells with hyperchromatic nuclei. Tumor cells are condensed around endocervical glands (H&E,X50).

Tumor lined by squamous epithelium beneath which dense cellular zone (cambium layer) containing small round, plump, spindle cells with hyperchromatic nuclei. (H&E,X100)

Embryonal Rhabdomyosarcoma : Tumor lined by squamous epithelium beneath which is dense cellular zone (cambium layer) containing small round, plump, spindle cells with hyperchromatic nuclei. (H&E,X100)

Tumor cells having round to oval hyperchromatic nuclei which are condensed around endocervical glands (H&E,X100)

Embryonal Rhabdomyosarcoma: Tumor cells having round to oval hyperchromatic nuclei which are condensed around endocervical glands (H&E,X100)

Condensed tumor cells underneath the epithelium. Myxomatous stroma shows hyaline cartilage (H&E,X50)

Embryonal rhabdomyosarcoma: Condensed tumor cells underneath the epithelium. Myxomatous stroma shows islands of hyaline cartilage (H&E,X50)

Myxomatous stroma shows islands of hyaline cartilage (H&E,X100)

Embryonal Rhabdomyosarcoma: Myxomatous stroma shows islands of hyaline cartilage (H&E,X100)

Condensed tumor cells underneath the epithelium. Myxomatous stroma shows islands of hyaline cartilage (H&E,X100)

Embryonal Rhabdomyosarcoma: Condensed tumor cells underneath the epithelium. Myxomatous stroma shows islands of hyaline cartilage (H&E,X100)