case_images: PMC7322231_01
case_images: Coronal and sagittal T2 weighted fat saturated images of the pelvic region show a large pelvi-abdominal elongated mass measuring 24 x 18 x 16.5 cm in the maximum dimensions. It extends from the right ischioanal, ischiorectal fat planes and traverses the right levator ani muscle. Inferiorly, it is displacing the rectum anteriorly and to the left in addition to displacing the uterus and urinary bladder anteriorly. The mass is isointense to muscle on T1 WI and has a relatively high signal intensity in T2 WI with linear low signal bands (swirl appearance) noted within. No definitive restriction was noted in the diffusion image sequence. Post contrast images demonstrate heterogeneous enhancement throughout. The internal low-intensity "swirled" signal was observable on all image sequences.
case_images: gr1.jpg
case_images: PMC7322231_01_gr1.jpg
case_images: fig0005
case_images: Inferiorly, it had a mass effect on the rectum anteriorly and to the left as well as on other pelvic organs, mainly the urinary bladder (Fig. 1).
case_images: Sagittal T1 fat suppressed post contrast sequence shows the pelviabdominal mass demonstrating heterogeneous enhancement and the characteristic swirled appearance.
case_images: gr2.jpg
case_images: PMC7322231_01_gr2.jpg
case_images: fig0010
case_images: Post contrast images demonstrated heterogeneous enhancement throughout with linear hypointensity "swirled" signals (Fig. 2).