Malignant neoplasm of the vagina. Right-sided pain and vaginal bleeding. History of grade 2 squamous carcinoma of the vagina. Patient with history of hysterectomy in 2005. PELVIS:UTERUS, ADNEXA: Patient is status post hysterectomy. There is an enhancing eccentric right vaginal, with central necrosis, measuring 4.5 x 3.4 cm. There is right parametrial invasion. BLADDER: The vaginal mass invades the posterior bladder serosa and causes buckling of the bladder mucosa (series 1201, image 39). LYMPH NODES: There is nonspecific mildly prominent pelvic lymph nodes. The largest left inguinal lymph node measures 1.4 x 1.3 cm (series 401, image 18). A representative left external iliac lymph node measures 1.2 x 0.8 cm (series 401, image 42).BOWEL, MESENTERY: The vaginal mass is tethered to the sigmoid colon, best identified on series 1201, image 34. There is no evidence of bowel obstruction. There is no ascites.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Ventral abdominal surgical scar.
Enhancing centrally necrotic vaginal mass (directed eccentrically to right) invading the bladder and right parametrium, with tethering and involvement of adjacent colon, consistent with known malignancy and accounting for patient's pelvic pain.