case_images: PMC7362981_01
case_images: On per speculum examination, cauliflower-like growth was seen
case_images: JMH-11-40-g001.jpg
case_images: PMC7362981_01_JMH-11-40-g001.jpg
case_images: F1
case_images: On per speculum examination, a cauliflower-like growth of about 6 cm x 8 cm was present completely filling the vagina [Figure 1].
case_images: (a) Sagittal T2-weighted magnetic resonance imaging shows T2 hyperintense mass (M) in the pelvis causing inversion of the uterus (U) seen as "V-shape" fundus; (b) axial T2-weighted magnetic resonance imaging shows inverted uterus (U) with "Bull's eye" configuration; (c) axial T2-weighted magnetic resonance imaging at a lower level shows the mass (M)
case_images: JMH-11-40-g002.jpg
case_images: PMC7362981_01_JMH-11-40-g002.jpg
case_images: F2
case_images: Her ultrasonography reported a large 5.9 cm x 3.4 cm x 6.3 cm heterogeneous mass in the vaginal canal with inferiorly displaced uterine fundus and body with the impression of large prolapsed submucosal fibroid with resultant inversion of uterus or a large cervical growth. Her contrast-enhanced computed tomography of the abdomen reported the inversion of the uterus and occupying the vaginal canal [Figure 2].
case_images: x10 is showing sprinkling positivity of CD10, consistent with high-grade stromal sarcoma
case_images: JMH-11-40-g003.jpg
case_images: PMC7362981_01_JMH-11-40-g003.jpg
case_images: F3
case_images: On immunohistochemistry, it was CD10-positive weakly [Figure 3], and tumor cells were negative for desmin, and thus the diagnosis of high-grade ESS with smooth muscle differentiation and heterologous element was made [Figure 4].
case_images: It showing frank areas of endometrial stromal tumor with foci of heterologous cartilaginous formation
case_images: JMH-11-40-g004.jpg
case_images: PMC7362981_01_JMH-11-40-g004.jpg
case_images: F4
case_images: On immunohistochemistry, it was CD10-positive weakly [Figure 3], and tumor cells were negative for desmin, and thus the diagnosis of high-grade ESS with smooth muscle differentiation and heterologous element was made [Figure 4].
case_images: Intraoperatively, vas-like appearance was seen
case_images: JMH-11-40-g005.jpg
case_images: PMC7362981_01_JMH-11-40-g005.jpg
case_images: F5
case_images: A vas-like appearance was seen [Figure 5] with both the ovaries, tubes, and round ligaments entering into the crater.