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There are two vaginal masses arising from the anterior vaginal wall, compressing the vaginal lumen which is displaced posteriorly with a blood-filled distended uterine cavity and upper vagina. These masses show an intermediate signal intensity as compared with the normal myometrium on T1WI, low signal intensity on T2 with heterogeneous enhancement on postcontrast sequences. A mass effect is noted on the bladder floor and urethra which are displaced anteriorly.
MRI features are suggestive of a vaginal leiomyoma.
Vaginal leiomyomas are an extremely rare entity, and fall under extrauterine pelvic leiomyomas.
It may occur anywhere along the vaginal canal. The anterior vaginal wall (as this in case) is the most common location.
Additional contributor: A Ramdani, MD