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Uterine rhabdomyosarcoma

Uterine rhabdomyosarcoma is a type of aggressive cancer that can appear in a woman's uterus. A Rhabdomyosarcoma is a rare type of soft tissue sarcoma that can grow in voluntary muscles like arms and legs or advance from mesenchymal cells after failing to fully develop into muscle cells or skeletal bone cells. The cells in this tumour are known as rhabdomyoblasts.

Types of Rhabdomyosarcoma's

There are four main subtypes of rhabdomyosarcoma's which are embryonal rhabdomyosarcoma, alveolar rhabdomyosarcoma, pleomorphic rhabdomyosarcoma, and spindle cell/sclerosing rhabdomyosarcoma. The alveolar and embryonal are the two main groups and they are most common in young adolescent soft tissues and the pleomorphic is usually seen in adulthood tissue. Embryonal is the most common type seen in children between the ages of 0-4 years old and it is shaped like a spindle with a stromal-rich appearance. This tumour type is mostly seen in the head and neck as well as the genitourinary tract. Alveolar is the second most common type affecting between 20-25% of people between the ages of 0-19. It develops in larger muscles such as arms and legs alongside the chest and stomach area too. The next most common one yet most aggressive type of sarcoma is the pleomorphic, however that is seen in mainly older people and is hard to discover due to the lack of separation between these types of cancers.

Types of Uterine Sarcoma's

Within these sarcoma's there are further specific types of cancer that can appear, thus there are four stages of uterine sarcoma's that can be seen and diagnosed. The first staging system is used for leiomyosarcoma's which affects the soft muscle tissue in the abdomen, and endometrial sarcoma's which is in the lining of the uterus. In the first stage, the tumour is found in the uterus only, meaning it likely can be treated minimally. Stage two consists of the tumour having spread from the uterus but no further from the pelvic area. In stage three, the cancer cells have developed into the abdomen, and in stage four it has spread to either the bladder and/or rectum or it has spread to other distant parts of the body. There is another type of uterine cancer called adenosarcoma which can appear in women of all ages and is a rare malignant tumour in the uterus and is most common post menopause. This undergoes the same four stages as well in terms of severity and diagnosis.

Testing for cancers

After diagnosis, tests are done to see whether the cancer cells have spread to other parts of the body to determine which staging level the tumour is at. Tests include a blood chemistry studies where a blood sample is taken to measure the substances released through the body. This indicates if a disease is present or if there is an abnormal amount of substance being pumped around the body. A chest X-ray is taken to check the organs and bones, ultrasounds and CT scans are also taken as precaution, a CA 125 assay is taken, which measures the amount in the bloodstream. A transvaginal exam is also taken to examine the vagina, uterus, fallopian tubes and bladder.

Signs and symptoms

There are multiple signs and symptoms for sarcoma's, which include a lump that you can see or feel, blockages in your nose and changes in swallowing or hearing, swollen eyes, stomach cramps, constipation, blood in your pee or difficulty peeing and vaginal discharge. In the body there are three ways that cancer can spread. The first one is blood as the cancer can travel through the vessels in the bloodstream to other parts of the body. The second way is through tissue, as it can spread by growing in nearby areas of the body. The third way is through the lymph system. It travels through the lymph system through the body.

Treatments

The main cause of treatment begins with surgery, where they can use it to diagnose, stage and treat cancers, sometimes even all at once, and there are multiple ways this can be approached. The first procedure that could be performed is a laparotomy where an incision is made along the wall of the abdomen to check inside for signs of disease. A abdominal and pelvic wash could be done where saline solution is places into the abdominal and pelvic body cavities. After a short while the solution is then removed again and examined under a microscope to check for any signs of cancer cells. Another procedure is a complete abdominal hysterectomy where the uterus and cervix are removed through a large incision in the abdomen. Sometimes the fallopian tubes and ovaries can be removed too for extra precaution. Doctors can do a bilateral salpingo-oophorectomy which consists of removing the fallopian tubes and the ovaries. There is also a lymphadenectomy which is a procedure in which the lymph nodes are removed and examined under a microscope for cancer cells and within this, it can vary whether some or all the suspected lymph nodes can be taken out at one time. It is often then followed by treatment including radiotherapy, chemotherapy, or hormone therapy.

References

1. https://www.macmillan.org.uk/cancer-information-and-support/soft-tissue-sarcoma/rhabdomyosarcoma

2. https://www.cancer.gov/types/uterine/patient/uterine-sarcoma-treatment-pdq

3. https://www.cancer.org/cancer/uterine-sarcoma/treating/by-stage.html