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case_images: Intraoperative photograph of the polypoid decidual ectopy. The entire surface is replaced with cystic-polypoid lesions of varying size. Both epithelial tissue types, squamous and glandular, show oedematous changes. Upon application of acetic acid (not shown) the majority of surface epithelium exhibited dense acetowhite changes. There was increased surface vascularity and spiralling vessels seen.
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case_images: Upon colposcopic visualisation (Fig. 1), the ectocervix showed an abnormal appearance, with hyperglandular protrusions and carpeted, cystic areas of varying size consuming the entire ectocervix.
case_images: Left panel, the antenatal magnetic resonance image at 30 weeks gestation shows a large cervical mass in the centre (green arrow). Right panel, showing the same area 20 weeks postpartum with normal female genital anatomy and no cervical mass.
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case_images: The MRI (Fig. 2, top panel) showed a gravid uterus with a mass seen centred on the anterior cervix and extending into the vaginal fornix measuring 40 x 47 x 15 mm. Given the extent of the cervical tumour antepartum, a pelvic MRI was repeated 20 weeks postpartum (Fig. 2, bottom panel) showing normal pelvic anatomy and no cervical mass.
case_images: Top panel, Frozen section of cervical biopsy, showing squamous ectocervical epithelium with decidualisation of subepithelial tissues, with large polygonal cells with abundant eosinophilic cytoplasm. There is no significant nuclear atypia, and no mitoses are seen. H&E stain. Original image taken at x20 magnification (left) and x40 magnification (right). Bottom panel, Frozen-to-paraffin section of cervical biopsy. High-power image showing endocervical glandular epithelium with decidualised subepithelial tissues, with large polygonal cells with abundant eosinophilic cytoplasm. Significant nuclear atypia is absent, and no mitotic figures are seen. A few small clusters of acute inflammatory cells (neutrophils) are noted within the epithelium. H&E stain. Original image taken at x20 magnification (left) and x40 magnification (right).
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case_images: Histopathology of the cervical biopsies (Fig. 3) showed florid decidual reaction with no evidence of malignancy.