Anyiam D C D, Ukah C O, Onyiaorah I V, Okafor N
Department of Histopathology, NAUTH, Nnewi.
Niger J Clin Pract. 2010 Sep;13(3):341-3.
Embryonal rhabdomyosarcomas (Sarcoma botyroides) are malignancies of connective tissue with abnormal cells which are thought to arise from skeletal muscle progenitors. It is a rare childhood malignant solid tumour and occurs in children mostly less than 10 years. It can occur at any age but two commonest peaks are 1-5 years (when approximately 66.6% occur) and 15-19 years accounting for the rest. Sarcoma botyroides which usually occurs in the vagina in childhood is rare in the female reproductive tract of adult women especially those over the age of 40. We report here a case of a 45-year-old HIV-positive woman who presented with profuse bleeding from the vagina with severe anaemia. Macroscopically, a cauliflower polypoid growth was seen protruding from the cervix into the vagina. Histopathological studies confirmed a diagnosis of sarcoma botyroides.
The need for a high index of suspicion of sarcoma botyroides of the cervix must be borne in mind when making a diagnosis on all cervical polypoidal masses. Also the importance of looking out for lesions and malignancies on all HIV positive patients cannot be over-emphasized.
胚胎性横纹肌肉瘤(葡萄状肉瘤)是一种结缔组织恶性肿瘤,其异常细胞被认为起源于骨骼肌祖细胞。它是一种罕见的儿童恶性实体瘤,主要发生在10岁以下的儿童。它可发生于任何年龄,但两个最常见的发病高峰分别是1 - 5岁(约占66.6%)和15 - 19岁(占其余部分)。葡萄状肉瘤通常发生于儿童期的阴道,在成年女性尤其是40岁以上女性的生殖道中罕见。我们在此报告一例45岁的HIV阳性女性,她因阴道大量出血伴严重贫血就诊。肉眼可见,一个菜花状息肉样肿物从宫颈突出至阴道。组织病理学研究确诊为葡萄状肉瘤。
在诊断所有宫颈息肉样肿物时,必须高度怀疑宫颈葡萄状肉瘤。同样,对于所有HIV阳性患者,留意病变和恶性肿瘤的重要性再怎么强调也不为过。