[A rare case of botryoid sarcoma of the uterine cervix: case report]

Botryoid sarcoma is a subtype of rhabdomyosarcoma affecting soft tissues and exceptionally the cervix. We here report the case of an 18-year-old female patient presenting to the emergency department with a feeling of pelvic heaviness, metrorrhagia and urinary retention. Gynecological examination showed budding mass of the uterine cervix. The biopsy showed botryoid sarcoma. Radiological evaluation revealed heterodense cervico-isthmic corporeal mass measuring 97 / 87 mm, without adenopathies or effusions or tumors at other sites. Treatment involved neoadjuvant chemotherapy with vincristine - adriamycin and cyclophosphamide (V-A-C), followed by surgery (total hysterectomy without adnexal preservation). After a follow-up of 3 years, the patient is still in clinical and radiological remission.

[Embryonal botryoid rhabdomyosarcoma of the uterus]

Rhabdomyosarcoma is a malignant neoplasm of mesenchymal origin with skeletal striated muscular differentiation. It is the most common sarcoma of childhood and has four subtypes: embryonal, alveolar, pleomorphic and spindle cell/sclerosing. Of all of them, the embryonal one is the most prevalent and presents a variant, botryoid, which usually involves hollow organs in the form of a multilobed polypoid mass. We present the case of a 27-year-old woman who consulted for vaginal bleeding and in whom colposcopy revealed a whitish polypoid lesion that was externalized through the external cervical os. Histological examination revealed cellular sectors alternated by lax, myxoid areas, together with typical isthmic-endometrial glands. The atypical spindle cell proliferation was arranged in nests, made up of ce lls with large eosinophilic cytoplasm with transverse cytoplasmic striations and eccentric nuclei with homogeneous chromatin. Areas of densely packed cells were exhibited immediately, but separated from, the intact epithelial lining by a thin layer of loose stroma (cambium layer). The immunostaining profile was positive for desmin, muscle-specific actin and myogenin, and negative for smooth muscle actin. A diagnosis of embryonal botryoid rhabdomyosarcoma of the uterine corpus was made.

Embryonal Rhabdomyosarcoma of the Cervix: A Rare Disease at an Uncommon Age

Embryonal rhabdomyosarcoma (RMS) is a rare type of sarcoma, primarily seen in the pediatric and adolescent population. Three subtypes of embryonal RMS are described, with the botryoid type being the most common. The incidence of this disease in adult females is 0.4% to 1% with the affected age group being patients in the third to fourth decade of life. It is exceedingly rare in patients above 40 years of age. We describe the case of a 48-year-old female, gravida 9 para 5, who presented with abnormal vaginal bleeding and an exophytic mass on examination. Given her lack of requirement of maintaining parity, she underwent radical surgery. The tumor was 8 cm in the largest dimension with a high histologic grade and some cartilaginous differentiation. Immunohistochemical stains were positive for vimentin, CD99, myogenin, and MyoD1 consistent with a diagnosis of embryonal rhabdomyosarcoma, botryoid subtype. Based on high survival rates when treated with aggressive adjuvant chemotherapy, a decision was made to treat the patient with the ARST0331 regimen. We discuss the diagnostic pathologic features of the disease, the epidemiology, and the most common presentation along with prognostic factors, treatment strategies, and outcomes.

[A rare cases of rhabdomyosarcoma of the uterine cervix: about a case and review of the literature]

Le rhabdomyosarcome du col utérin fait partie des types histologiques rares des cancers du col, qu'on observe généralement chez la jeune fille ou la femme en période d'activité générale. La stratégie thérapeutique se base sur l'association des trois modalités thérapeutiques (chimiothérapie-radiothérapie-chirurgie) vu l'agressivité de la maladie. Nous rapporterons ainsi un cas de rhabdomyosarcome du col utérin chez une fille de 20 ans. Il s'agit d'une patiente âgée de 20 ans, rapportant comme antécédents pathologique particulier la notion d'infection génitale à répétition. Le premier signe rapporté était des métrorragies abondantes avec à l'examen la présence d'une masse cervicale en grappe de raisin. La biopsie était en faveur d'un rhabdomyosarcome du col. Le bilan d'extension montrait une masse localement avancée sans métastase. La patiente a reçu 5 cures de VAC avec une régression du processus tumoral de 90%. Patiente fut opérée et a bénéficié d'une hystérectomie sans conservation des annexes. Puis elle a bénéficié d'une radiothérapie postopératoire sur le pelvis. Le recul était de 13 mois, la patiente est toujours en rémission complète. Le RMS du col utérin est une tumeur rare qui survit essentiellement chez la jeune fille. L'extension est surtout locorégionale. Le traitement consiste en un geste chirurgical allant d'un éventuel traitement conservateur jusqu'au traitement radical associé à une chimiothérapie péri-opératoire. La place de la radiothérapie demeure imprécise.

Testing the ontogenetic base for the transient model of inflorescence development

BACKGROUNDS AND AIMS

Current research in plant science has concentrated on revealing ontogenetic processes of key attributes in plant evolution. One recently discussed model is the 'transient model' successful in explaining some types of inflorescence architectures based on two main principles: the decline of the so called 'vegetativeness' (veg) factor and the transient nature of apical meristems in developing inflorescences. This study examines whether both principles find a concrete ontogenetic correlate in inflorescence development.

METHODS

To test the ontogenetic base of veg decline and the transient character of apical meristems the ontogeny of meristematic size in developing inflorescences was investigated under scanning electron microscopy. Early and late inflorescence meristems were measured and compared during inflorescence development in 13 eudicot species from 11 families.

KEY RESULTS

The initial size of the inflorescence meristem in closed inflorescences correlates with the number of nodes in the mature inflorescence. Conjunct compound inflorescences (panicles) show a constant decrease of meristematic size from early to late inflorescence meristems, while disjunct compound inflorescences present an enlargement by merging from early inflorescence meristems to late inflorescence meristems, implying a qualitative change of the apical meristems during ontogeny.

CONCLUSIONS

Partial confirmation was found for the transient model for inflorescence architecture in the ontogeny: the initial size of the apical meristem in closed inflorescences is consistent with the postulated veg decline mechanism regulating the size of the inflorescence. However, the observed biphasic kinetics of the development of the apical meristem in compound racemes offers the primary explanation for their disjunct morphology, contrary to the putative exclusive transient mechanism in lateral axes as expected by the model.