MRI of rare vaginal tumors: Report of two cases

Abstract

Tumors of the vagina are overall rare and unexplored entities and thus often pose diagnostic dilemmas. We report two rare malignant vaginal tumors and their magnetic resonance imaging (MRI) appearances. We describe two cases of rare vaginal malignancies. In the first case of a 29-year-old married, nulliparous woman, MRI revealed a T2 heterogeneous peripherally enhancing mass involving the upper vagina and the cervix. The uterus was uninvolved. A biopsy was obtained, which showed features of choriocarcinoma. In the second case of a 13-year-old adolescent girl, MRI revealed a T2 hyperintense, moderate to intensely enhancing mass within the vagina. The patient was examined, and tissue sampling was obtained, which showed embryonal rhabdomyosarcoma (RMS). Primary choriocarcinoma and embryonal RMSs of the vagina are extremely rare. Choriocarcinomas are treated by chemotherapy and RMSs by chemotherapy, surgery, and/or radiation therapy. Accurate characterization and staging on imaging help in appropriate intervention.

Magnetic Resonance Imaging of a Rare Case of Primary Choriocarcinoma of the Vulva

“…On T2 weighted images, they are heterointense with a hypointense rim. On contrast administration, they exhibit peripheral enhancement with non-enhancing areas indicating necrosis (7,8). The imaging features in our case are similar to all the features thus described.…”

“…Extrauterine choriocarcinoma is extremely rare and the cervix is the commonest site (2). Only four cases of primary vulvovaginal choriocarcinoma and two cases of primary vaginal choriocarcinoma are found in literature, with imaging features described only for purely vaginal lesions (3,4,5,6,7,8). The commonest presenting feature is abnormal vaginal bleeding with elevated β-hCG, as seen in our case (2).…”

“…Med. We make research great again: peer reviewed and open access vascular, as evidenced by the flow voids and avid enhancement in the center of the lesion in our case (2,7,9). Choriocarcinomatous lesions contain abundant venous plexus without valves, which makes them prone to torrential hemorrhage, due to which biopsy is not routinely advised when β-hCG is rising or elevated (10).…”