Recurrent Cervical Sarcoma Botryoides in a 3-Year-Old Female: Approach in a Limited Resource Setting
| Autor: | Wita Saraswati Oesman, Dwi Krisna Imawan, Alfonsus Adrian Hadikusumo Harsono, Sjahjenny Mustokoweni, Nia Kania, Firas Farisi Alkaff, Hariadi Yuseran |
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| Rok vydání: | 2019 |
| Předmět: |
Vincristine
medicine.medical_specialty Uterine Cervical Neoplasms 030204 cardiovascular system & hematology Malignancy Metastasis 03 medical and health sciences 0302 clinical medicine Biopsy medicine Humans Outpatient clinic Rhabdomyosarcoma Embryonal Rhabdomyosarcoma medicine.diagnostic_test business.industry Infant Articles General Medicine medicine.disease Surgery Indonesia Child Preschool 030220 oncology & carcinogenesis Sarcoma botryoides Health Resources Female Embryonal rhabdomyosarcoma Neoplasm Recurrence Local business medicine.drug |
| Zdroj: | The American Journal of Case Reports |
| ISSN: | 1941-5923 |
| DOI: | 10.12659/ajcr.915608 |
| Popis: | Patient: Female, 3 Final Diagnosis: Recurrent sarcoma botryoides Symptoms: Vaginal mass Medication: — Clinical Procedure: Surgical resection • adjuvant chemotherapy Specialty: Obstetrics and Gynecology Objective: Unusual setting of medical care Background: Sarcoma botryoides, known as embryonal rhabdomyosarcoma (ERMS), is a malignant tumor which arises from embryonic muscle cells. The incidence of ERMS in the uterine cervix rarely occurs at a very young age. With sufficient resources, management of this disease is not difficult. However, in limited resources settings, such as in Indonesia, the situation is more challenging. This case report aims to highlight the difficulties encountered in diagnosing and treating patients with sarcoma botryoides. Case Report: A 3-year-old female patient came the outpatient clinic of our hospital with a protruding mass from her vagina resembling a bunch of grapes which easily bled. She underwent surgery to remove the mass. After the procedure, she did not return to the hospital for the recommended adjuvant chemotherapy treatment due to limited funds. Three months later, she came to the outpatient clinic with the same complaint, despite smaller size. Due to limited resources, we only evaluated the metastasis using chest x-ray and did not perform intra-operative biopsy. In the second surgery, a wide excision with 1–2 cm margin was performed, followed by adjuvant chemotherapy for 6 series. We achieved a satisfactory outcome in this case, and 18 months after the surgery, the patient was still in remission. Conclusions: Sarcoma botryoides is a rare malignancy. The effective treatment for sarcoma botryoides is wide excision with safe margin of 1–2 cm, followed by 6–12 cycles of vincristine, actinomycin D, and cyclophosphamide (VAC) regiment as an adjuvant chemotherapy. A family’s understanding of the treatment plan is important to achieve desired outcomes. Even with limited resources, this malignancy can still be properly treated. |
| Databáze: | OpenAIRE |
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