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Muscle-bound

Magnetic resonance imaging helped define a large paraurethral mass
      A 43-year-old woman had a paraurethral mass causing discomfort during sexual activity. Physical examination revealed a firm, smooth, nontender, nonfluctuant mass without any associated discharge. It was located anterior to the urethral meatus and inferior to the clitoris (Figure 1). Magnetic resonance imaging (MRI) demonstrated a well-circumscribed, pedunculated growth measuring 2.1 × 1.9 × 2.1 cm (Figure 2). On T1-weighted images, its signal intensity was lower than that of muscle. T2-weighted images indicated that the mass had a higher signal than muscle, and it was encircled by a hyperintense signal similar to that of peripheral fluid.
      Figure thumbnail gr1
      FIGURE 1Large paraurethral mass anterior to urethral meatus and inferior to clitoris.
      Hubert. Muscle-bound. Am J Obstet Gynecol 2009.
      Figure thumbnail gr2
      FIGURE 2Paraurethral mass captured with magnetic resonance imaging. A, Mass (arrow) in axial T1-weighted image had lower signal intensity than that of muscle within distal vagina. B, Axial T2-weighted image shows mass (arrow) with signal intensity slightly higher than that of muscle. It is surrounded by high-intensity signal similar to that associated with fluid (arrowhead). C, Sagittal T2-weighted image shows mass (arrow) arising from anterior urethral wall and pedunculated from area between meatus and clitoris. Signal intensity is slightly higher than that of muscle.
      Hubert. Muscle-bound. Am J Obstet Gynecol 2009.
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