Prolapsed endometrial polyp into entire vaginal canal

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Metrorrhagia with a mass visible through the vaginal orifice on the gynecological examination.

Patient Data

Age: 45 years
Gender: Female
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Info

Normal size and echotexture of the uterus. Echogenic mass fills the uterine cavity and extends through the endocervical canal filling the entire vagina (white arrows).

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Info

Well-defined pedunculated intracavitary soft tissue mass (length = 10 cm), arising from the fundal wall, prolapsing into the entire vaginal canal through a moderately enlarged endocervical canal. It displays an isosignal on T1, intermediate to high signal on T2 with surrounding hyperintense endometrium and no restricted diffusion. The postcontrast sequences show a heterogeneous enhancement. No infiltration of the myometrium. No pelvic lymphadenopathy is seen. Minimal effusion in Douglas pouch and in inter vesicouterine space.

Case Discussion

Ultrasound and MRI features most consistent with an endometrial polyp prolapsed into the entire vaginal canal.

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