GYNECOLOGICAL COMPLICATIONS OF BOTTRIOID SARCOMA

Abstract

Introduction: Botryoid sarcoma, an embryonal variant of rhabdomyosarcoma, is a rare malignant tumor that predominantly affects the female genital tract, especially in infants and young children. Characterized by its polypoid growth and grape-like appearance, this tumor is highly aggressive and can infiltrate adjacent tissues and result in significant gynecological complications. Clinical manifestations include abnormal vaginal bleeding, muco-bloody discharge, and a protruding mass in the vulva, which are often confused with benign pathologies, delaying diagnosis and compromising prognosis. Objective: To investigate the main gynecological complications associated with botryoid sarcoma, analyzing its pathophysiology, clinical manifestations, and therapeutic approaches described in the scientific literature of the last 10 years. Methodology: The study followed the PRISMA checklist guidelines and used the PubMed, SciELO, and Web of Science databases. Five descriptors were used in Portuguese and English: “Bothrioid Sarcoma”, “Embryonal Rhabdomyosarcoma”, “Gynecological Complications”, “Vaginal Tumors” and “Oncogynecology”. The inclusion criteria included original studies, systematic reviews and clinical trials that addressed the gynecological complications of botryoid sarcoma. Articles that did not specify gynecological complications, studies with inadequate methodology and publications in languages ​​other than Portuguese, English and Spanish were excluded. Results: The studies analyzed demonstrated that botryoid sarcoma frequently resulted in gynecological complications such as post-treatment vaginal stenosis, infertility and urinary dysfunction due to the anatomical proximity of the tumor to the urethra and bladder. Cervical obstruction and tumor recurrence were identified as significant therapeutic challenges. In addition, the response to treatment varied according to the diagnostic stage, with late diagnoses being associated with worse clinical outcomes and a higher rate of lung and lymph node metastasis. Conclusion: The gynecological complications of botryoid sarcoma reflected the aggressiveness of this tumor and the challenges imposed on its management. Early diagnosis, associated with individualized therapeutic strategies, was essential to minimize sequelae and improve the prognosis of patients. The multidisciplinary approach and long-term follow-up proved to be fundamental in reducing complications and preserving quality of life.