Volume 13, Issue 2 (2-2015)                   IJRM 2015, 13(2): 113-116 | Back to browse issues page

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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. IJRM 2015; 13 (2) :113-116
URL: http://ijrm.ir/article-1-618-en.html
A successful pregnancy during the treatment of cervical sarcoma botryoides and advantage of fertility sparing management: A case report
Selçuk Ayas1 , Lutfiye Uygur * 2, Evrim Bostanci1 , Ayşe Gürbüz3
1- Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Research and Training Hospital, Turkey
2- Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Research and Training Hospital, Turkey , lutfiyeuygur@gmail.com
3- Department of Gynecology, Kadıköy Florence Nightingale Hospital, Turkey
Abstract:   (2828 Views)
Background: Sarcoma botryoides of cervix is a rare variant of rhabdomyosarcomas (RMS) of female genital tract. It is usually diagnosed in first or second decade of life. In this case report, we aimed to present a 21 year-old nulligravid patient who was diagnosed with embryonal RMS of the cervix, to discuss the treatment options that have been stated in the literature, and to highlight the advantage of fertility sparing management in these young patients.
Case: We report a 21-year-old nulligravid woman complaining about a mass protruding from introitus, which was represented with a 8×7 cm “grape-like” cervical polyp on speculum examination. The histopathologic examination of the biopsy taken was combined with immunohistochemical staining with desmin, myogenin, S100, vimentin, and myoglobin. Colposcopy, second biopsy, and positron emission tomography were used during the follow-up. The histopathologic examination revealed embryonal RMS of cervix. She received three cycles of combination chemotherapy, doxorubicin and ifosfamide. She refused to have a surgery because of an unplanned, desired pregnancy at two months after the chemotherapy. She was lost during the follow-up. After having an uneventful pregnancy and a successful delivery, she reapplied at postpartum 6th month. Colposcopic evaluation revealed a local polypoid area, the histopathologic examination of biopsy suggested recurrence even though positron emission tomography scans were unremarkable. Therefore complementary treatment was planned as conization and pelvic lymphadenectomy. The histopathology revealed no residual tumor on the conization material and no involvement of pelvic lymph nodes.
Conclusion: Fertility sparing management, including doxorubicin and ifosfamid combination in chemotherapy step, can be management option. Pregnancy and successful delivery is possible during the treatment. Colposcopy has importance for early detection of recurrences
Keywords: Rhabdomyosarcoma, Embryonal, Cervix, Pregnancy, Fertility sparing.
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