Swelling of the vaginal mucosa is a symptom caused by the subcutaneous production of embryonal rhabdomyosarcoma. Clinical attention should be paid to the differential diagnosis with the following symptoms. 1, neuroblastoma Tumors occur in children under 5 years of age, mostly located in the adrenal glands, sympathetic nerve chains on both sides of the spine and visceral plexus; light microscopy shows small and round cells, and tumor cells may form chrysoidal clusters; immunohistochemical staining shows positive for NSE and NF and negative for Desmin and Myoglobin Both tumors are found in children and adolescents and may be located in bone or soft tissue; they are composed of small round cells of uniform size and tightly arranged; immunohistochemical staining expresses CD99 and does not express myogenic markers. 3.Children’s pro-connective tissue proliferative small cell tumor is a malignant tumor that occurs in the abdominal cavity of children and consists of small round cells. The tumor lacks the characteristics of rhabdomyoblast differentiation and has significant connective tissue surrounding the nest of tumor cells; immunohistochemical staining can express CK, EMA, Vimentin, NSE and S-100 protein to varying degrees, but not myoglobin and MyoD1, in addition to Desmin. 4.Malignant rhabdomyosarcoma The tumor is mostly located in The tumors are mostly located in the kidney of children, but may also be located in soft tissues outside the body. The tumor consists of loosely arranged ovoid or polygonal cells with abundant cytoplasm and PAS-positive eosinophilic red inclusion bodies. Malignant rhabdomyosarcoma cells express wave proteins, CK and EMA, but not Desmin and Myoglobin. Malignant melanoma Malignant melanoma composed of small nevus cells may occasionally be mistaken for rhabdomyosarcoma, and the cells are carefully searched for intracellular melanin granules, which express S-100 and HMB45, but not Desmin and Myoglobin. The diagnosis of malignant melanoma can be confirmed by confirming intracytoplasmic melanosomes under electron microscopy. 6.Malignant lymphoma Tumor cells express LCA, B or T lymphocyte antigens, but not Desmin and Myoglobin, which can be differentiated from rhabdomyosarcoma. 7.Granulocytic sarcoma Tumor cells express MPO and do not express myogenic antigens, which can be distinguished from embryonal rhabdomyosarcoma. Small cell carcinoma Most commonly seen in middle-aged and elderly people, tumor cells express CK and EMA, sometimes NSE, SYN and CgA, but not Desmin and Myoglobin. 9. Infantile pigmented neuroectodermal tumor, poorly differentiated synovial sarcoma and angiosarcoma are distinguished. Immunohistochemistry showed that infantile pigmented neuroectodermal tumors expressed NSE, SYN and CgA; synovial sarcoma expressed Vimentin, CK and EMA; and angiosarcoma expressed CD31, CD34 and factor VIII-associated antigen.