Vaginal mass in a 16-month-old child

• Sarcoma botryoides is an embryonal rhabdomyosarcoma that has an excellent prognosis with early diagnosis and treatment. • Clinical features of the tumor typically include an obvious and rapidly enlarging mass protruding from the genital region. • Staging of disease should include biopsy of the mass and any suspicious lymph nodes, bone scan, bilateral bone marrow biopsies, and CT scan/MRI of the chest, abdomen, and pelvis. Renal ultrasonography should be considered if urethral or bladder involvement is suspected. • Treatment of sarcoma botryoides has improved over the past 20 years, and a multimodal approach combining chemotherapy, radiation, and surgery has decreased the morbidity previously associated with treatment of this disease.