PMC6076939_01
Lesion on exam under anesthesia and gross specimen during dissection.
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There was also a 0.5x1.0 cm exophytic lesion overlying the mass with serosanguinous drainage (Figure 1).
Transvaginal ultrasound. (a) Gray scale image shows a mixed echogenicity mass (arrows) with small hypoechoic cystic areas (3.0 MHz) 10 cm. (b) Color Doppler image shows minimal vascularity. Magnitude: 3 MHz.
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A pelvic ultrasound (US) was performed and showed a complex vaginal mass, inseparable from the cervix, measuring 5.1 x 3.8 x 5.4 cm (Figure 2(a)). Color Doppler demonstrated minimal peripheral vascularity (Figure 2(b)).
(a) Sagittal T2 weighted image shows a predominantly hyperintense mass (arrows) with small central areas of hypointensity. (b) On T1 weighted axial image the mass is homogeneously hypointense (arrows). (c) Sagittal contrast enhanced image demonstrates heterogeneous hyperenhancement inferiorly (dashed arrow) and absent enhancement superiorly (*). Cervix: cx.
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Magnetic resonance imaging (MRI) was subsequently performed for further characterization (Figure 3).
(a) Mesenchymal lesion with alternating hypercellular and hypocellular areas (4x magnification; hematoxylin and eosin stain). (b) Higher magnification demonstrating ovoid and spindle-shaped cells aggregated around small blood vessel (40x magnification).
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Nuclei were round or ovular with fine chromatin (Figure 4).