Robert L. Lebowitz, M.D. Children' s Hospital, Harvard Medical School Boston, Massachusetts

This little girl, now 3 1/2 years old, had been noted to have a mass coming out of her vagina (Figure 1*) when her mother was changing her diaper.   Evaluation included ultrasonography (Figure 2), which showed that the vagina was filled with tumor, and an MRI scan (Figure 3a) (Figure 3b) that also showed the tumor in the vagina and invading or emanating from the cervix.   The bladder was displaced to the right.

She underwent hysterectomy and the ovaries were moved up and out of the field to protect them from future radiation injury.   Each ovary was marked with a surgical clip to show its new location. (Figure 4)

*Figure 1 is of a different patient.