PMC6524541_01
The importance of the bleeding led to an embolization of the vaginal artery with coil fixing. (A) Before embolization. (B) After embolization.
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F1
We partially stopped the bleeding by dabbing with silver nitrate but as the bleeding was not totally stopped, we performed an embolization of the right and left vaginal arteries with coils (Figure 1).
Vaginal biopsies. The tissue transmitted for pathological analysis corresponds to endometrium, with numerous glands slightly irregular in size and shape lined by cylindrical cells without nuclear atypia, and densely cellular stroma with signs of ancient bleeding, rare mitotic figures, and no cytologic atypia. (A) Hemalun Eosin, magnification x4. (B) Hemalun Eosin, magnification x 10.
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F2
A first vaginal biopsy under local anesthesia produced two small fragments of endometrial tissue with no atypia or malignancy (Figure 2).
Comparison of the 2013 and 2018 CT scanner showing an enlargement of the vaginal mass from 48 x 24 mm to 76 x 47 mm.
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F3
The abdominal CT scan and MRI found a hypodense mass adjoining the vaginal dome possibly infiltrating the posterior bladder wall and the rectum (Figure 3).
CT-scann guided core biopsies of a pelvic mass. This second series of biopsies again samples endometrium with a slightly denser stroma composed of fusocellular cells with rare mitotic figures and no significant atypia. (A) Hemalun Eosin, magnification x4. (B) Hemalun Eosin, magnification x 10.
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F4
The CT scan-guided biopsy produced small pieces of endometrium with limited stromal changes (mild stroma hyper-cellularity, with no significant atypia and very rare mitotic figures), with no evidence of a malignant tumor (Figure 4).