Gynaecological oncology: sarcoma botryoides: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Gynaecological oncology: sarcoma botryoides

Sample item

A 2-year-old girl has bloody vaginal discharge, and examination shows a polypoid grape-like mass protruding from the vagina. Biopsy shows small round cells positive for desmin. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Embryonal rhabdomyosarcoma (sarcoma botryoides)

Sarcoma botryoides is an embryonal rhabdomyosarcoma of the vagina, presenting in infants and young girls as a grape-like mass with bleeding. Cells stain for desmin and myogenin. Treatment is multimodal chemotherapy with limited surgery, which has replaced radical exenteration.

Option by option

  • A. Clear cell adenocarcinoma

    Clear cell adenocarcinoma is linked to in-utero diethylstilbestrol exposure in adolescents.

  • B. Endodermal sinus tumour

    Yolk sac tumours cause an elevated AFP and can arise in the vagina, but do not form a grape-like mass with desmin positivity.

  • C. Embryonal rhabdomyosarcoma (sarcoma botryoides) (correct)

    Correct. A grape-like vaginal mass in an infant is sarcoma botryoides.

  • D. Vaginal condyloma

    Condylomas are warty and not desmin positive.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Embryonal rhabdomyosarcoma (sarcoma botryoides). Sarcoma botryoides is an embryonal rhabdomyosarcoma of the vagina, presenting in infants and young girls as a grape-like mass with bleeding.

Why is "Clear cell adenocarcinoma" not the answer?

Clear cell adenocarcinoma is linked to in-utero diethylstilbestrol exposure in adolescents.

Why is "Endodermal sinus tumour" not the answer?

Yolk sac tumours cause an elevated AFP and can arise in the vagina, but do not form a grape-like mass with desmin positivity.

Why is "Vaginal condyloma" not the answer?

Condylomas are warty and not desmin positive.

What concept does this question test?

It tests Gynaecological oncology: sarcoma botryoides in OBG. Cells stain for desmin and myogenin. Treatment is multimodal chemotherapy with limited surgery, which has replaced radical exenteration.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gynaecological oncology: sarcoma botryoides?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.