Vaginal Endometriosis: An Enigma for Clinicians

Prerna Lakhwani, Kapil Kumar
In: Indian Journal of Gynecologic Oncology · 2019 · vol. 17(2) · doi:10.1007/s40944-019-0279-0 · W2931333822
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-12 ⓘ

This case report describes a 19-year-old female with vaginal endometriosis presenting as a polypoidal growth, surgically excised and medically managed with GnRH analogs, resulting in symptom resolution.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This paper describes a clinical case of vaginal endometriosis in a 19-year-old woman with a polypoidal vaginal growth mimicking carcinoma, alongside irregular vaginal bleeding, cyclical protrusion during menstruation, dysmenorrhea, and right iliac fossa pain. Imaging (MRI) suggested bilateral adnexal masses with a focal soft-tissue lesion involving the right posterolateral fornix, and on examination the lesion was excised (3 × 4 cm) with diathermy; histology confirmed endometriosis. The patient then received six months of monthly intramuscular depot GnRH analog injections and became symptom free, with follow-up exams and excision plus medical management reported as alleviating anxiety for the patient and her parents. As a single-case report with no comparative design, the main limitation is its inability to generalize beyond this patient. This paper is centrally about endometriosis — it focuses on vaginal endometriosis presenting as a malignancy-mimicking polyp and describes diagnosis and treatment in that setting, with MRI also noting bilateral adnexal masses suggestive of adenomyosis-related pelvic findings.

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Abstract

Endometriosis is the presence of ectopic endometrial tissue that responds to hormonal stimulation. Although it occurs most often in pelvis, several unusual sites have been reported like skin, umbilicus, vagina, etc. The pivotal case here is a 19-year-old lady who presented with a vaginal polypoidal growth mimicking carcinoma vagina. She gave a history of irregular vaginal bleeding since 3 years and something protruding through the vagina periodically before and during menstrual period. It was accompanied by moderate-to-severe dysmenorrhea and persistent pain in right iliac fossa. MRI was suggestive of B/L Adnexal masses with focal soft tissue lesion involving Right posterolateral fornix. On EUA, patient had a 3 × 4 cm polypoidal tongue-like vascular growth arising from right posterolateral fornix which was totally excised using diathermy. The histological exam of the tissue showed features of endometriosis. The patient was managed by monthly i/m injections of Depot preparation of GnRH analogs for 6 months. The patient now is absolutely symptom free. EUA and excision followed by proper medical management allayed the anxiety of patient and her parents.

References

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