Huge Rare Vaginal Fibromatosis in Postmenopausal Woman, Case Report and Literature Review, 2022

Background: Pelvic fibromatosis or desmoids tumor is an uncommon benign mesenchymal tumor that usually involves the vulvo-vaginal area in women of reproductive age, which are slow growing and painless mass. Case Report: A 70-year post-menopausal woman from Asmara presented with genital swelling which grows gradually over 15 years. She had history of trans-abdominal hysterectomy for abnormal uterine bleeding before 20 years. She had also history of right sided body weakness due to cerebro-vascular accident for the last10 years. She had no known chronic diseases such as hypertension or diabetes mellitus. On physical examination, she is a wheelchair patient with right sided hemiplegia and old midline abdominal scar. On genitourinary examination, patient had a large, about 20x18cm, non-tender, irregular, nodular mass, that hangs from the right side of the labia majora to the level of one third of upper thigh. She had also multiple nodular lesions around the ano-genital area. Different laboratory baseline investigations revealed normal finding. She was operated on 30/10/2022 and a 4kg vulvar mass was resected with right partial hemi-vulvoctomy and sample was sent for pathology which revealed fibromatosis. She was discharged with full improvement and currently on follow-up for possible recurrence. Conclusion: This is reported for its rarity and its enormously large size, slow growing and non-invasive nature. Besides, this was atypical being in a postmenopausal woman, and it’s important to highlight that desmoids tumors should be included in the differential diagnosis of any vulvar mass. She was managed with surgical intervention as it was extremely big. Enhancing community and health professionals’ awareness on similar health problems is crucial for early intervention of similar r conditions.