BACKGROUND Sarcoma botryoides, known as embryonal rhabdomyosarcoma (ERMS), is a 
malignant tumor which arises from embryonic muscle cells. The incidence of ERMS 
in the uterine cervix rarely occurs at a very young age. With sufficient 
resources, management of this disease is not difficult. However, in limited 
resources settings, such as in Indonesia, the situation is more challenging. 
This case report aims to highlight the difficulties encountered in diagnosing 
and treating patients with sarcoma botryoides. CASE REPORT A 3-year-old female 
patient came the outpatient clinic of our hospital with a protruding mass from 
her vagina resembling a bunch of grapes which easily bled. She underwent surgery 
to remove the mass. After the procedure, she did not return to the hospital for 
the recommended adjuvant chemotherapy treatment due to limited funds. Three 
months later, she came to the outpatient clinic with the same complaint, despite 
smaller size. Due to limited resources, we only evaluated the metastasis using 
chest x-ray and did not perform intra-operative biopsy. In the second surgery, a 
wide excision with 1-2 cm margin was performed, followed by adjuvant 
chemotherapy for 6 series. We achieved a satisfactory outcome in this case, and 
18 months after the surgery, the patient was still in remission. CONCLUSIONS 
Sarcoma botryoides is a rare malignancy. The effective treatment for sarcoma 
botryoides is wide excision with safe margin of 1-2 cm, followed by 6-12 cycles 
of vincristine, actinomycin D, and cyclophosphamide (VAC) regiment as an 
adjuvant chemotherapy. A family's understanding of the treatment plan is 
important to achieve desired outcomes. Even with limited resources, this 
malignancy can still be properly treated.