Vaginectomy and Buccal Mucosa Vaginoplasty as Local Therapy for Pediatric Vaginal Rhabdomyosarcoma

We report a case of vaginal rhabdomyosarcoma where vaginectomy with buccal mucosa vaginoplasty was performed to avoid radiation therapy to the young pelvis. The patient presented at 30 months with an exophytic vaginal mass, found to be botryoid rhabdomyosarcoma. After receiving neoadjuvant vincristine, actynomycin D, and cyclophosphamide chemotherapy with good response, she underwent surgery. It was performed using an anterior sagittal approach on the prone position, which allowed for a safe circumferential dissection of the vagina all the way to the cervix and en bloc resection. Two buccal mucosa grafts were used for vaginoplasty. Pathology revealed negative margins. The patient completed therapy in October 2014 and remains disease-free.