Primary gynecologic lymphoma is rare. Nonetheless, the distinction between primary and secondary involvement is important because of critical differences in prognosis and treatment. The prospective diagnosis of primary gynecologic lymphoma enables immediate chemotherapy or radiation therapy and avoids unnecessary surgery, which delays treatment. Diagnostic imaging can be key in differentiating lymphoma from the far more common pelvic malignancies.

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This case represents a rare presentation of an intramedullary insertion of the patellar tendon in an otherwise healthy 8-year-old girl. To our knowledge no such phenomenon has previously been reported in the English literature.