Magnetic resonance imaging diagnosis of a rare entity: Primary vaginal adenosis

Many tissues undergo metaplasia in response to chronic inflammation, infection, and environmental factors like chemicals and viruses. This metaplastic change can be in the form of gland formation (adenosis). Adenosis of the vaginal mucosa is rare and has been recorded in the past secondary to in-utero exposure to diethyl stilbesterol (DES). Here the authors report a case of a 29-year-old female patient being evaluated for primary infertility who was diagnosed with vaginal adenosis on magnetic resonance imaging (MRI). MRI revealed numerous, variably sized, submucosal cysts diffusely involving the vaginal mucosa from the introitus to the fornices without any preference for the anterior or posterior walls. The MRI diagnosis was confirmed on biopsy and histopathology. The patient had an uneventful postoperative recovery and continues to be under treatment for infertility.