A 33-year-old nulligravid Filipino woman was admitted to the gynaecology ward of Princess Margaret Hospital in April 2014, with lower abdominal pain and recurrent retention of urine. Her pregnancy test was positive. Per-vaginal examination revealed a 4-cm firm, fixed, and wide-based vaginal mass with smooth wall over the upper anterior vagina. Bedside transabdominal ultrasonography confirmed a 4.5-cm solid mass in the anterior vagina and a 3. <5.0 IU/L for non-pregnant women), and repeated checking 3 days later was 253 957 IU/L. Alphafetoprotein, carcinoembryonic antigen, and Ca-125 were negative. A urologist was consulted and the patient underwent flexible cystoscopy that revealed indentation of the urinary bladder by an external mass. Mild erythematous changes were visualised at the right urinary bladder base. Biopsy revealed inflammation but no malignant cells.Magnetic resonance imaging (MRI) of the pelvis revealed a 4.8 cm x 5.2 cm x 4 cm (craniocaudal x anteroposterior x transverse) mass located at the anterior aspect of the vagina. It was hypointense with a faint hyperintense rim on T1-weighted images (Fig 1a) and heterogeneously hyperintense CASE REPORT