Symptom triad of primary cervical rhabdomyosarcomas as seen in a Nigerian tertiary hospital: A case series.

Introduction: Primary cervical rhabdomyosarcomas (PCR) are exceedingly rare and lack a standardized management protocol. Limited data exist about clinical presentation, pathology, and optimal treatment options. This study reviews all confirmed cases of PCR at our institution over a 12-year period. Methods: Case notes, and pathology reports of all women diagnosed with PCR at our institution from January 1, 2011, to March 31, 2023, were retrospectively reviewed and summarized. Results: Nine cases of PCR were identified, all of the embryonal variant. The median age at presentation was 19 years (range 3-40), with 33.3% (n = 3) of patients being children (less than 18 years) at diagnosis. All patients presented with at least one of the following symptoms: protrusion per vagina, vaginal bleeding, or vaginal discharge. Many presented with procidentia and a distinctive gelatinous, copious non-foul-smelling mucoid discharge. Surgery was the most common treatment modality, offered in 88.9% (n = 8) of cases, combined with chemotherapy in half of these. One patient received radiotherapy. One patient did not receive any form of treatment. As of April 2023, with a median follow-up of 36 months, six patients were alive with no clinical evidence of disease recurrence, one had died of disease, one died of unrelated causes, and the outcome of one patient could not be ascertained. Conclusion: The triad of a cervical mass with procidentia, slimy mucoid discharge, and vaginal bleeding in women of reproductive age should heighten clinical suspicion for primary cervical rhabdomyosarcomas. The overall prognosis and survival rate appear to be favorable in this series.