Presentation
Pelvic pain with vaginal bleeding
Patient Data
Age: 40 years
Gender: Female
From the case:
Primary vaginal carcinoma
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The MRI sequences demonstrate:
- a large lobulated vaginal mass seen as an irregular thickening of the vaginal walls
- displays an intermediate signal on TWI, slight high signal on T2WI relative to muscles with moderate and heterogeneous enhancement on postcontrast sequences and restricted diffusion on DWI/ADC
- superiorly the mass appears in contact with the external os with no invasion of the cervical canal
- posteriorly there is an invasion of the anterior rectal wall
- anteriorly the mass appears in contact with the base of the bladder with no apparent invasion
- laterally, there is bilateral extension mainly on the left with infiltration of the vaginal fornix and parametrium
- inferiorly there is an infiltration of the left levator ani muscles
- bilateral iliac lymphadenopathy
- moderate ascites with peritoneal nodules indicating peritoneal carcinomatosis
- a left ovarian hemorrhagic cyst is noted
Case Discussion
MRI features of a vaginal tumor, histopathologically proven as a primary vaginal carcinoma (squamous cell carcinoma).
Primary vaginal carcinomas are rare. The squamous cell carcinoma of the vagina is by far the commonest subtype.
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