PMC5949183_01
Sagittal section of MRI showing the 45 mm x 50 mm solid mass in the vesicovaginal septum in relation to the uterus, mass, and vagina (V).
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On Magnetic Resonance Imaging, a 45 mm x 50 mm solid mass in the vesicovaginal septum with a well-defined margin was demonstrated (Figure 1).
Ultrasound scan showing relation of mass to uterus and vagina.
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A repeat ultrasound scan demonstrated a 2.9 cm left ovarian cyst, suggestive of an endometrioma and a solid mass inferior to the uterus and anterior to the vagina, displacing the bladder (Figure 2).
View of mass on diagnostic laparoscopy; uterus anteverted.
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The vaginal mass was removed with laparoscopic assessment via a midline incision on the anterior vaginal wall with lateral dissection around the cystic structure (Figures 3-6).
Marsupialisation of vaginal mass from anterior vaginal wall.
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The vaginal mass was removed with laparoscopic assessment via a midline incision on the anterior vaginal wall with lateral dissection around the cystic structure (Figures 3-6).
Excision of vaginal mass from anterior vaginal wall.
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The vaginal mass was removed with laparoscopic assessment via a midline incision on the anterior vaginal wall with lateral dissection around the cystic structure (Figures 3-6).
Cut surface of mass.
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The vaginal mass was removed with laparoscopic assessment via a midline incision on the anterior vaginal wall with lateral dissection around the cystic structure (Figures 3-6). Histopathological macroscopic assessment of the mass showed pale tan tissue surrounded by a thin capsule and on sectioning a homogeneous whorled tan tissue (Figure 6).
Cross section showing alternating hypercellular areas around blood vessels (H) and hypocellular (O) areas containing slender collagen fibrils with no evidence of necrosis.
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Aggregation of cells around vessels was noted and there were no atypical mitoses, necrosis, or atypia (Figures 7 and 8).