Sarcoma botryoides of the cervix: A report of two cases

Sarcoma botryoides, or embryonal rhabdomyosarcoma, is probably the most common form of rhabdomyosarcoma encountered in gynaecology. 1 The rhabdomyoblast is capable of giving rise to a number of different neoplasms, classified by Horn and Enterline (1958) as embryonal, botryoid, alveolar and pleomorphic. 2 The botryoid turnout consists of embryonal-type cells and originates in a submucosal cellular zone of primitive rhabdomyoblasts, known as the cambium layer of Nicholson. Its classical polypoid or grape-like appearance is related to this submucosal location. Sarcoma botryoides is the most common neoplasm of the lower genital tract in girls under 16 years of age, 3 with 90% of patients presenting before the age of 5 years. 4 Patients seen in late adolescence or older tend to have disease at the upper end of the genital canal; the upper vagina, the cervix, or the uterine corpus. 5 The peak incidence of cervical sarcoma botryoides is the second decade. 6 Eighty per cent of patients present with either abnormal vaginal bleeding or a mass in the vagina, with approximately 75% presenting with Group I disease. In 1975, the Intergroup Rhabdomyosarcoma Study group recommended a staging system for classifying patients with rhabdomyosarcoma (Table 1). This has subsequently been used by authors in describing and detailing cases. 7