Clinical and magnetic resonance imaging characteristics of vaginal and paraurethral leiomyomas: can they be diagnosed before surgery?

Abstract

Study Type – Diagnostic (non‐consecutive) Level of Evidence 3b OBJECTIVE To describe the clinical and magnetic resonance imaging (MRI) characteristics of vaginal and paraurethral leiomyomas. PATIENTS AND METHODS All patients with pathologically confirmed paraurethral and vaginal wall leiomyomas from January 2006 to August 2007 were reviewed. Patients with no preoperative MRI of the pelvis were excluded. RESULTS Five patients were identified; all had a firm, smooth, non‐tender, non‐fluctuant mass. MRI showed a well‐circumscribed shape, a homogeneous signal that was hypointense or isointense to muscle on T1‐ and hyperintense or isointense to muscle on T2‐weighted images, and uniform enhancement. In all cases, MRI excluded urethral diverticulae, and pathology showed leiomyoma, of which one had atypical features. CONCLUSION Paraurethral and vaginal wall leiomyomas can be identified before surgery with a reasonable degree of certainty, based on their clinical and MRI characteristics.

Vaginal paraurethral leiomyoma

“…8 Transabdominal and or transvaginal ultrasonography and MRI are helpful in establishing the morphology and relationship with adjacent anatomic structures although these tests are not mandatory pre-operatively. 9,10 Surgical enucleation is the treatment of choice via vaginal approach. 11 In our case the mass was superficial and easily accessible hence surgery was done with minimal morbidity.…”

Paraurethral leiomyoma in a woman: a case report

“…MRI can clinch the diagnosis, with a reasonable degree of certainty. 4 However, if the mass is freely mobile, advanced radiographic techniques may be avoided.…”

Vaginal Leiomyoma: Case Report and Literature Review

“…30 Rapid enlargement mimicking a vaginal malignancy has also been reported by Sim et al 30 Diagnosis is usually difficult preoperatively as it can mimic cystocele or cervical fibroid but USG and magnetic resonance imaging (MRI) usually clinch the diagnosis. 31 Translabial sonography should be considered as an adjunct to transabdominal and transvaginal sonography for patients with suspected vaginal fibroids. 32 The MRI shows well-demarcated solid masses of intermediate signal intensity in T1-and T2-weighted images with homogeneous contrast enhancement, while leiomyosarcomas and other vaginal malignancies show high T2 signal intensity with irregular and heterogeneous areas of necrosis or hemorrhage.…”