Clear Cell Carcinoma Presented as a Large Polypoid Mass Expanding the Vaginal Fornix: Report of Two Cases

Fig. 1
A 16-year-old girl with cervical clear cell carcinoma.
A. A transabdominal sonogram shows an about 7.5 cm sized, relatively homogeneous solid mass lesion (arrows) in vagina. Uterus (white arrow) is normally well seen.

B. Sagittal T2-weighted MR image shows a heterogeneous polypoid mass lesion. It expands the vaginal fornix and is attached to the exocevix by a stalk (arrow).

C, D. Axial pre-enhanced (C) and Gadolinium-enhanced (D) T1-weighted MR images show a relatively homogeneous, iso-intense mass lesion to the buttock muscle with a strongly enhancing pedicle (arrow).

E. Photomicrograph of the mass shows neoplastic cell proliferation which consists tubules and cysts with multiple papillary projection and solid sheets of clear cells. The tubules (arrows) are lined by cuboidal to tall columnar hobnail cells. Most cells have large hyperchromatic round nuclei with clear abundant cytoplasm (H&E stain, × 200).

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Fig. 2
A 26-year-old girl with vaginal clear cell carcinoma, uterine didelphys and left ovarian mature teratoma.
A, B. Non-enhanced CT scan (A) shows an isodense mass (white arrow) in vagina and it is heterogeneously and strongly enhanced on post-enhanced scan (B). Two cervices (black arrows) and left ovarian teratoma are seen.

C, D. Coronal T2-weighted images show two endometrial cavities (white arrows), a left ovarian teratoma and a heterogeneous polypoid mass lesion (black arrow) expanding the vaginal fornix.

E-I. The mass is a heterogeneous high signal intensity on T2-weighted image (E) and homogeneous intermediate signal intensity on axial T1-weighted image (F). It is progressively and strongly enhanced with time on dynamic Gadolinium-enhanced T1-weighted images (G-I). The stalk of the mass (arrow) is well seen on T2-weighted image (E).

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