case_images: PMC11100634_01
case_images: A heterogeneously enhancing mass at the uterine cervix related to known carcinosarcoma with mild extension to the proximal endovaginal canal. (a) Axial image and (b) Lateral image
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case_images: Large well defined heterogeneously enhancing mass at the uterine cervix is related to a carcinosarcoma with mild extension to the proximal endovaginal canal, and suspicion of early evidence of parametrial invasion [Figure 1].
case_images: (a) Rhabdomyoblast is infiltrated in the cervical stroma, nonneoplastic endocervical glands are seen in between (arrows), and cartilaginous lobule (heterologous element) with nuclear atypia is seen in the right side. H and E, x100. Atypical nuclei of hyaline cartilage with high magnification (inset) H and E, x 400, (b) Rhabdomyosarcoma with label of hyaline cartilage (heterologous element) and periglandular cuffing H and E, x 400
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case_images: The histological grade was low grade [Figure 2].
case_images: (a) Nuclear pleomorphism with abundant, eosinophilic cytoplasm, and one highly anaplastic multinucleated bizarre tumoral cell H and E, x 400, (b) Anaplastic rhabdomyoblasts were found in several foci. H and E, x 400
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case_images: The immunohistochemistry (IHC) was done and its results showed [Figure 3] positive desmin, Myo D1, and cytoplasmic staining WT 1 and negative smooth muscle actin (SMA) with a diagnosis of ERMS (BOTRROID type) of the uterine cervix.
case_images: (a) Rhabdomyosarcoma with cellular condensation underlying squamous (cambium layer) H and E, x 100, (b) Primitive round cells with abundant eosinophilic cytoplasm. The rhabdomyoblastic nature of the tumor cells is determined by the small rounded to spindle-shaped tumor cells with eccentric nuclei and eosinophilic tails of eosinophilic cytoplasm (magnification of inset) H and E, x 400
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case_images: CK, CYCLIN, DESIM, and PAX8 and negative in C-KIT, SMA, GATA-3, CD10, NAPSIN-A, and ER factors. Carcinoma with heterologous component ERMS was our final diagnosis [Figure 4].
case_images: Decreasing size of uterine cervix sarcoma with downward extension representing respond to treatment
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case_images: The patient underwent four sessions of neoadjuvant chemotherapy with AIM, doxorubicin, ifosfamide, and mesna [Figure 5].
case_images: Immunohistochemistry staining for myogenin labeled rhabdomyoblastic cell nuclei. (a) H and E, x 100 high magnification of tumor cells nuclei stained with myogenin, (b) H and E, x 400
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case_images: The pathological result after the surgery showed embryonic RMS with heterologous element [Figure 6].