PMC7362981_01
On per speculum examination, cauliflower-like growth was seen
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F1
On per speculum examination, a cauliflower-like growth of about 6 cm x 8 cm was present completely filling the vagina [Figure 1].
(a) Sagittal T2-weighted magnetic resonance imaging shows T2 hyperintense mass (M) in the pelvis causing inversion of the uterus (U) seen as "V-shape" fundus; (b) axial T2-weighted magnetic resonance imaging shows inverted uterus (U) with "Bull's eye" configuration; (c) axial T2-weighted magnetic resonance imaging at a lower level shows the mass (M)
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F2
Her ultrasonography reported a large 5.9 cm x 3.4 cm x 6.3 cm heterogeneous mass in the vaginal canal with inferiorly displaced uterine fundus and body with the impression of large prolapsed submucosal fibroid with resultant inversion of uterus or a large cervical growth. Her contrast-enhanced computed tomography of the abdomen reported the inversion of the uterus and occupying the vaginal canal [Figure 2].
x10 is showing sprinkling positivity of CD10, consistent with high-grade stromal sarcoma
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F3
On immunohistochemistry, it was CD10-positive weakly [Figure 3], and tumor cells were negative for desmin, and thus the diagnosis of high-grade ESS with smooth muscle differentiation and heterologous element was made [Figure 4].
It showing frank areas of endometrial stromal tumor with foci of heterologous cartilaginous formation
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F4
On immunohistochemistry, it was CD10-positive weakly [Figure 3], and tumor cells were negative for desmin, and thus the diagnosis of high-grade ESS with smooth muscle differentiation and heterologous element was made [Figure 4].
Intraoperatively, vas-like appearance was seen
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F5
A vas-like appearance was seen [Figure 5] with both the ovaries, tubes, and round ligaments entering into the crater.