Emergency Radiation Therapy for Hemorrhage in Botryoides Sarcoma: A Pediatric Case Report

BACKGROUND Botryoid rhabdomyosarcoma is a subtype of embryonal rhabdomyosarcoma and is a rare and highly vascular malignant childhood tumor, with the most common sites of origin being the vagina and cervix in young girls. This report describes the case of a 15-year-old girl presenting with vaginal hemorrhage due to botryoid rhabdomyosarcoma treated with emergency radiation therapy. Hemorrhage in botryoid rhabdomyosarcoma can present as a life-threatening emergency requiring immediate intervention. This case highlights the role of emergency external radiation therapy as a valuable adjunct in managing hemorrhage in botryoid rhabdomyosarcoma, especially when surgical options are limited. CASE REPORT We report a case of a 15-year-old girl who experienced repeated profuse episodes of vaginal bleeding and protruding mass in the vagina for 2 months. She had no significant medical history or family history of cancer. Magnetic resonance imaging (MRI) confirmed a massive malignant mass in the vaginal introitus that infiltrated the cervix, extending to the uterus. Based on the histopathology result, the diagnosis was botryoid rhabdomyosarcoma with a primary site located on the cervix, and due to the emergency situation and the risks associated with surgical intervention, emergency external radiation therapy was initiated. After 1 session of radiation therapy, the bleeding was significantly reduced. CONCLUSIONS Hemorrhage in botryoid rhabdomyosarcoma is a rare but critical complication. Emergency external radiation therapy helps stabilize the patient with acute bleeding caused by botryoid rhabdomyosarcoma. Further research is needed to find the optimal treatment strategies.