An Unusual Fibrohistiocytic Lesion of the Pelvis Presenting as Vaginal Bleeding in a Prepubertal Female: A Clinical, Pathological, and Immunohistochemical Study

We report a case of a 5-year-old female who presented with vaginal bleeding of unexplained etiology. There was no evidence of precocious puberty by history and physical examination. Endocrine laboratory studies were in the normal range for a prepubertal female. On vaginoscopy, a friable, granulomatous mass that bled easily was discovered within the vaginal vault. Pelvic sonography and magnetic resonance imaging of the pelvis was significant for a left adnexal mass. Surgical exploration and histological analysis revealed an unusual fibrohistiocytic proliferation. This unusual case broadens the differential diagnosis for vaginal bleeding in the prepubertal child (Table1).