Ewing sarcoma/primitive neuroectodermal tumor (PNET) of the rectovaginal septum
Presentation
Pelvic pain with vaginal bleeding
Patient Data
The MRI sequences demonstrate a large relatively well-circumscribed pelvic soft tissue mass (9 x 7.6 x 7.5 cm) centered on the rectovaginal septum with endovaginal extension through a large defect of the posterior vaginal wall, well-visualized on both axial and sagittal sequences. It displays an intermediate signal with areas of high signal on T1, inhomogeneous high signal on T2 with restricted diffusion on DWI/ADC. The postcontrast sequences show a heterogeneous enhancement with large centrotumoural necrosis. No apparent extension to the anterior rectal wall. Mild effusion in Douglas pouch is noted.
Normal appearance of the uterus and both ovaries.
Case Discussion
MRI features of a large tumor centered on the rectovaginal septum with endovaginal extension through a large defect of the posterior vaginal wall.
A transvaginal biopsy with histopathological exam and immunochemistry study was performed which were in favor of an Ewing sarcoma/primitive neuroectodermal tumor (PNET).
Ewing sarcoma or PNET is considered as a rare neoplasm of the genital tract. Only a few cases were reported in the literature.
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