Case of superficial myofibroblastoma protruding from the posterior fornix treated using laparoscopic surgery

Abstract

Superficial myofibroblastoma is a very rare benign mesenchymal tumor that develops in the cervix, vagina, and vulva.We report a case of superficial myofibroblastoma that was diagnosed following laparoscopic surgery for a vaginal tumor arising from the posterior fornix. The patient was a woman in her 40s (gravida 0). A flexible vaginal tumor with a smooth surface was observed arising from the posterior fornix. Magnetic resonance imaging revealed a neoplastic lesion with no signs of malignancy. We performed total laparoscopic hysterectomy and vaginal tumor resection because of the presence of multiple uterine fibroids. We made an incision in the vaginal wall on the vulva side of the tumor and removed it together with the uterus without breaking the tumor. Histopathological examination revealed superficial myofibroblastoma. The tumor was difficult to diagnose based on clinical symptoms and imaging findings. The differential diagnosis included tumors with poorer prognosis, such as aggressive angiomyxoma; thus, surgery with the aim of complete resection was required. Complete resection was possible by laparoscopically removing the uterus and tumor.