A 13-year-old girl, otherwise healthy, presented with complaints of a painless vaginal mass associated with intermittent abnormal vaginal bleeding and discharge over a few weeks. External examination of genitalia was unremarkable and pubertal development was appropriate for her age. No obvious abnormality was detected on recto-abdominal examination. No transvaginal examination was attempted in view of the patient’s age and she was directly referred to a trans-perineal ultrasound scan that showed an ill-defined lobulated heterogeneous vaginal mass. On further evaluation with dynamic contrast magnetic resonance imaging (MRI) of the pelvis, a lobulated polypoid mass was noted protruding from the cervical orifice into the upper two thirds of the vagina. This mass demonstrated heterogeneous high T2 (Fig. 1a) and low T1 (Fig. 1b) signal intensity with mild central enhancement on delayed post contrast sequences (Fig. 1c). The rest of the pelvic organs were unremarkable.
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