Presentation
Exophytic perineal mass lesion.
Patient Data
There is a rounded lobulated T2 intermediate, T1 isointense to muscle lesion in contact with the vagina. The lesion is associated with uterine prolapse and a large cystocele.
The lesion shows a mild restriction on diffusion-weighted imaging.
No pathologic lymph nodes are seen.
The lesion is avidly enhanced on PET-CT.
Pathology:
Infiltrative squamous cell carcinoma of condylomatous type (warty) of the cervix or vagina, not HPV-related (no P16 overexpression).
Case Discussion
This case shows a squamous cell carcinoma of the vagina with a fungating pattern, which can be seen in about 30% of cases. The other possible forms are ulcerating (50%) and annular constricting (20%).
The prognosis for an exophytic lesion such as in the current case is better than for infiltrative disease.
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