Alveolar Vaginal Rhabdomyosarcoma in an Adult: A Rare Case Report and Comprehensive Literature Review

Department of Oncology, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, University Hassan II, Morocco

*Corresponding Author: Dr. Zineb Kabala, Department of Oncology, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, University Hassan II, Morocco, Phone: 0615449640, Email: [email protected]

Received Date: April 25, 2025

Published Date: May 24, 2025

Citation: Kabala Z, et al. (2025). Alveolar Vaginal Rhabdomyosarcoma in an Adult: A Rare Case Report and Comprehensive Literature Review. Mathews J Case Rep. 10(3):207.

Copyrights: Kabala Z, et al. © (2025).

ABSTRACT

Rhabdomyosarcoma (RMS) is a rare and aggressive malignant tumour arising from mesenchymal tissue with skeletal muscle differentiation. Although it mainly affects children and adolescents, its presence in the female genital tract, particularly the vagina, is exceptionally rare. Among its histological subtypes, alveolar rhabdomyosarcoma (ARMS) is recognised for its aggressive nature, poor prognosis and distinct molecular features. Despite advances in multimodal treatment strategies, the prognosis and optimal management of vaginal RMS are still under investigation. Given its early non-specific symptoms and potential for rapid progression, early diagnosis is essential to improve patient outcomes. We report a rare case of a 58-year-old divorced woman, mother of one, with a family history of gastric cancer (maternal grandmother). The patient's symptoms began six years prior with recurrent episodes of scant metrorrhagia, which were initially neglected due to preserved general condition. The worsening of bleeding prompted medical consultation. A pelvic ultrasound revealed an enlarged uterus with a 5 cm intra-cavitary mass. A pelvic MRI showed a solid-cystic abdomino-pelvic mass measuring 82 x 85 mm, suspicious for a tumor of either peritoneal or ovarian origin. An exploratory laparoscopy was performed, with biopsy of a peritoneal mass and excision of a vaginal mass. Histopathological analysis confirmed a diagnosis of alveolar rhabdomyosarcoma of the vagina, an extremely rare malignancy in adults. Further staging with CT imaging revealed peritoneal carcinomatosis and pulmonary nodules, which were confirmed by biopsy to be metastatic in nature. A complete biological work-up was normal. The patient received two cycles of first-line chemotherapy (vincristine, dactinomycin, and cyclophosphamide), but unfortunately died 21 days after the second cycle due to rapid disease progression. This case highlights a rare and aggressive form of vaginal alveolar rhabdomyosarcoma in adults, characterized by late diagnosis, metastatic spread, and poor prognosis, despite appropriate therapeutic intervention.

Keywords : Alveolar Rhabdomyosarcoma, Vaginal Tumor, Soft Tissue Sarcoma, Genitourinary.