Clinical manifestations and MRI features of vaginal endodermal sinus tumors in four children.

ABSTRACT

BACKGROUND: Vaginal endodermal sinus tumor is a rare entity. OBJECTIVE: The purpose of this study was to report the clinical manifestations and MRI features in a case series. MATERIALS AND METHODS: Children with vaginal endodermal sinus tumor admitted to our hospitals between January 2008 and August 2012 were included. MRI was performed in all four children and diffusion-weighted imaging was performed in two children. RESULTS: Four children, mean age 14 months, were included. All had a history of vaginal bleeding. Serum alpha-fetoprotein was significantly elevated on admission. Relative to muscle, the vaginal masses were uniformly isointense on T1-weighted images, heterogeneously hyperintense on T2-weighted images and heterogeneously enhancing on contrast-enhanced images. The vaginal masses were obviously hyperintense on diffusion-weighted images (b value, 800 s/mm(2)). Extravaginal invasion was observed in three children. Pelvic lymphadenopathy was noted in two children and pulmonary metastasis was found in one child. CONCLUSION: MRI may contribute in the evaluation of vaginal endodermal sinus tumors.