Case 19 Answer

Large fair uniformly hyperdense mass posterior to the bladder with no Doppler flow. MRI above

Answer: Imperforate hymen with distended posterior vagina and uterine cavity (aka hematometrocolpos)

You don’t see these every day but it is something to keep in the back of your mind in a young female.It should be fairly apparent with a good history and physical, so you also don’t want to look silly calling it cancer.