PMC6582828_01
Computed Tomography (CT) scan of the abdomen and pelvis. Arrow heads show hypodense contrast enhancing mass (a) seen on the uterus (b) arising from the cervical region (c).
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Tomography (CT) scan of the abdomen and pelvis which helped to know the extent of the mass and reported hypodense contrast enhancing mass seen on the uterus arising from the cervical region measures about 10.3 cm by 14.4 cm. The mass grows down in to the vagina and concluded with the diagnosis of contrast enhancing cervical mass likely myoma (Figure 1).
The arrows in the above picture taken intraoperative show the right ovary (A), the right fallopian tube (B), uterus (C), vaginal wall mass pushed up, (D) and bladder (E).
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Intraoperatively, bilateral fallopian tubes and ovaries, the uterus, and urinary bladder grossly look normal; there is 10 cm by 15 cm sized firm mass between the vagina and the lower uterine segment (Figure 2).
Gross appearance of the excised mass (blue arrow).
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Then another 6 cm longitudinal incision was made on the posterior vaginal wall; sharp and blunt dissection were made to separate the bulk of mass away from the vaginal wall; finally excision of the mass from the base within 1 cm of normal vaginal tissue was performed to carefully remove a 15 x 10 x 7 cm encapsulated mass (Figure 3).
The gross picture of the cervix (blue arrow) and anterior vagina (black arrow) after excision of the mass.
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The anterior vaginal wall, extension of incision on the cervix, and posterior vaginal wall closed separately with vicryl number 0 in two layers (Figure 4).
Microsection shows tumor tissue fragments comprised of abundant fibrous tissue (arrow heads) having benign proliferating spindle cells, myxoid areas, and proliferating dilated blood vessels in between.
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The final pathological diagnosis of the mass was vaginal angiofibroma (Figure 5).