A vaginal fibroepithelial stromal polyp: a case report with magnetic resonance images

A fibroepithelial stromal polyp is a benign soft tissue tumour that can occur in the vagina, vulva and uterine cervix. Magnetic resonance imaging (MRI) findings have been reported in patients with vulvar fibroepithelial stromal polyps, not in those with vaginal polyps. We present MRI findings of vaginal fibroepithelial stromal polyp in a postmenopausal female. A 1 to 2 cm firm vaginal mass arising from the left side of the vaginal wall with hypointense signal changes on T1W MRI was identified. A well-defined vaginal mass (1 cm diameter) was detected with inhomogeneous signal intensity on T2W images. However, a major portion had high signal intensity on diffusion-weighted images. A benign vaginal lesion with oedematous changes or myxoid degeneration was suspected. Vaginal resection was performed, and fibroepithelial stromal polyp was pathologically diagnosed. MRI may be a useful non-invasive modality for preoperatively diagnosing vaginal fibroepithelial stromal polyps.

A Case of Ovarian Dysplasia and a Vaginal Fibroleiomyoma in a Young Golden Retriever

This case demonstrates a unique ovarian congenital anomaly that likely contributed to the development of a rare fibroleiomyoma in the cranial vagina of a young bitch. A 13 month old intact female Golden Retriever presented to the veterinary teaching hospital for urinary incontinence, hematuria, and persistent vaginal discharge. Physical examination revealed a mucopurulent serosanguinous malodorous vulvar discharge, and after further diagnostics was reclassified as persistent estrus. Abdominal palpation and ultrasound revealed uterine thickening and poorly visualized ovaries. The reproductive tract was removed during an ovariohysterectomy, revealing small ovaries and a white anterior vaginal mass. Histopathology revealed dysplastic ovaries with hyperplastic granulosa cells and a benign vaginal fibroleiomyoma. These morphologic changes are consistent with elevated estrogen levels. It was thus concluded that her persistent estrus and the fibroleiomyoma were both secondary to persistent estrogen production by the hyperplastic granulosa cells.

A Paraurethral Vaginal Mass in Rural Setting: A Case Report

Paraurethral vaginal leiomyoma is the infrequent case to be described. Approximately 300 cases have been described so far. Imaging modalities aid in identifying the morphological, structural characteristics of the mass and its relationship to the surrounding structures. Thirty-six years old married women presented with a vulvar mass of (3x5) cm2. Her associated complaints were left shift of the urinary stream and dyspareunia. Ultrasonography and cystography revealed a mass with no relationship with bladder or uterine structure. Surgical excision was performed. The histopathological report confirmed the diagnosis of paraurethral vaginal leiomyoma. Surgical excision is the treatment of choice and diagnosis is confirmed by histopathological examination.

Leiomyoma of levator ani muscle

Epithelioid leiomyomas of the vagina are extremely rare benign smooth muscle tumors. Leiomyomas are located in uterus in 70%; however, paravaginal leiomyomas are rare, which frequency is 0.1% in adults women. They can be asymptomatic, but if they are, may cause signs of compression, dyspareunia, urinary disorders,… The diagnosis is made by histologic and immunohistochemical examination, helped by imaging tests such as RMN and ultrasound. The first treatment option is the resection by enucleation. Search of information was carried out in the PubMed/Medline, Cochrane, SciELO databases and references from articles in journals and recent published texts. This is a case report of a 29-years-old female who is derived to Gynecologic Emergencies because of a Bartholinitis refractory to antibiotic treatment. The gynecological exploration reports a vaginal mass which extends to left paravaginal space. The biopsy of this mass suggests the diagnosis of leiomyoma. MRI study reports a 49mm mass in left ischiorectal space which seems to depend on puborectal muscle. The resection is made by enucleation, with a histopathological examination that confirms the diagnostic suspicion.

Case Report: Adenocarcinoma Of The Appendix Presenting As A Cervical Polyp.

Background: The differential diagnosis of a vaginal mass after hysterectomy is broad. Malignancies of the genital tract or metastasis from another primary tumor should be excluded. Appendiceal carcinoma is a rare cause, case reports are limited.Case presentation: A 77-year-old woman with a history of vaginal hysterectomy presented with a 12-month history of vaginal pressure. The vaginal mass, penetrating trough the cervix, is resected (vaginal approach). A Microscopic examination of the removed tissue revealed an adenocarcinoma of the appendix. Right hemicolectomy, resection of the vaginal vault and resection of the regional lymph nodes showed no residual tumor.Conclusions: Full diagnostic work-up of a vaginal mass should be performed to avoid unexpected malignancy. Transvaginal resection was in this case feasible and safe.

Primary mixed large cell neuroendocrine and high grade serous carcinoma of the endometrium

Endometrial large-cell neuroendocrine carcinoma admixed with a high-grade serous (HGS) adenocarcinoma is extremely rare with only one reported case in the literature. We present the second reported case in a 47-year-old woman who presented with abdominal pain, distension and loss of weight. On examination she had a fixed pelvic mass and vascular left vaginal mass. Imaging confirmed a 13 cm solid cystic rectouterine pelvic mass, omental disease and retroperitoneal lymphadenopathy. She underwent a modified posterior exenteration, partial posterior vaginectomy, omentectomy and Hartmanns procedure with suboptimal debulking. Histopathology revealed a stage 4B mixed carcinoma with large cell neuroendocrine (70%) and HGS carcinoma (30%). Eight cycles of adjuvant cisplatin and paclitaxel were given with a complete radiological and biochemical response after 7 months. Unfortunately, she developed widespread recurrence at 9 month and was offered second line chemotherapy.