Vaginal leiomyoma: A case report

Introduction and importance

Leiomyomas can affect 20–30% of women of reproductive age and are commonly observed in the uterus. Their occurrence in the vagina is exceedingly rare, representing the least common presentation among all locations. Herein, we report a case of vaginal leiomyomas in a 48-year-old lady.

Case presentation

A 48-year-old female presented to our gynecology clinic complaining of feeling a mass within her vagina. Physical examination revealed a round, smooth mass in the anterior vaginal wall with a normal-looking cervix. Ultrasound examination showed an enlarged anteverted uterus with an endometrial thickness of 14 mm and an endometrial polyp of 15 × 7mm arising from the left upper anterolateral wall. Magnetic resonance imaging demonstrated a well-defined, fusiform, submucosal vaginal mass originating from the anterior vaginal wall, measuring 37× 22 × 36 mm. Hysteroscopy was performed, and the uterine and vaginal masses were resected. The masses were confirmed to be conventional leiomyomas.

Clinical discussion

The diagnosis is seldom established preoperatively and the preferred therapeutic approach for treating vaginal leiomyoma is surgical removal via the vaginal route. However, in the case of large tumors, the abdominoperineal route may be necessary.

Conclusion

Vaginal leiomyoma is a rare tumor with approximately 300 reported cases worldwide. It can be asymptomatic or cause to feel it within the vagina. Besides the necessity of surgical resection, colporrhaphy as a reconstructive surgery may be required.