PMC6720055_01
Preoperative T2 axial MRI though the pelvis demonstrating ACCBG lesion in the right vulva.
CRIOG2019-1784949.001.jpg
PMC6720055_01_CRIOG2019-1784949.001.jpg
fig1
The lesion appeared to infiltrate the vaginal wall in the anteromedial margin, but this did not cross the midline (Figure 1).
Histological slide of the ACCBG specimen. Cribriform and tubular glands infiltrating the submucosa of the vulva. There are pseudoglandular spaces with excess basement membrane material and mucin. Foci of perineural invasion are present. The tumour involves excision margins.
CRIOG2019-1784949.002.jpg
PMC6720055_01_CRIOG2019-1784949.002.jpg
fig2
On histology, the specimen had foci of perineural invasion and invaded fibrous tissue, fat, and skeletal muscles (Figure 2).
Postoperative T2 axial MRI through the pelvis demonstrating high T2 signal in the right pudendal nerve.
CRIOG2019-1784949.003.jpg
PMC6720055_01_CRIOG2019-1784949.003.jpg
fig3
FDG uptake consistent with postsurgical changes and uptake in a right axillary node that was likely inflammatory rather than a distant metastasis. Further MRI contrast scans to assess extent of perineural invasion showed linear enhancement along the course of the perineal branch of the right pudendal nerve, terminating before Alcock's canal (Figure 3).