Differential Diagnosis between Bartholin Cyst and Vulvar Leiomyoma: Case Report

Tavares, Kelly Alessandra da Silva; Moscovitz, Thomas; Tcherniakovsky, Marcos; Pompei, Luciano de Melo; Fernandes, César Eduardo

doi:10.1055/s-0037-1604178

Cited by 11 publications

(17 citation statements)

References 9 publications

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“…Whereas in several other reports, the patients had one to two recurrences during a median follow up period of 25 months, others found no recurrence at one or two years, as was the case in our patient (2,30,31). Complete enucleation or excision of the tumor with surrounding normal tissue decreases the rate of recurrence and increases the ve-year survival rate (5,30). Considering the small number of cases and limited available follow-up data, the long-term clinical behavior of vulvar leiomyoma remains to be established.…”

Section: Discussioncontrasting

confidence: 52%

“…From 25 smoothmuscle tumors of the vulva analysed in that study, 19 were followed up to an average of 5 years and four had local recurrence and one distant metastasis was found (5). Whereas in several other reports, the patients had one to two recurrences during a median follow up period of 25 months, others found no recurrence at one or two years, as was the case in our patient (2,30,31). Complete enucleation or excision of the tumor with surrounding normal tissue decreases the rate of recurrence and increases the ve-year survival rate (5,30).…”

Section: Discussionsupporting

confidence: 46%

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Challenges in Management of Bartholin gland Leiomyoma: A Case Report

Vinturache

Ismail

Damato

et al. 2020

Preprint

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Abstract Background: Leiomyomas are uncommon vulvar neoplasms often misdiagnosed as other Bartholin gland pathology. Due to their rarity and the absence of guidelines, their diagnosis and management remain challenging, largely based on expert opinion and evidence from case reports. Case Presentation: This case report describes a 44-year-old woman presenting with accelerating growth of a vulvar mass. Based on clinical signs and symptoms, the initial diagnosis was Bartholin cyst. Surgical excision was provided for symptom control and aesthetic reasons. The histopathologic diagnosis was vulvar leiomyoma. The postoperative recovery was complicated by secondary haematoma and dehiscence of the surgical site. There was no recurrence at two years follow up. Therefore, we discuss the dilemma posed by physical examination of a vulvar mass, the challenges of the management, and report on secondary morbidity and long-term follow up, aspects of care for patients with vulvar pathology not commonly addressed in the literature. Conclusions: Bartholin gland neoplasms are rare tumors, commonly misdiagnosed as Bartholin’s cysts. Excision is the treatment of choice. Short time follow up allows prompt management of potential postoperative complications. Continuing long term follow up is recommended due to recurrence risk.

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Section: Discussioncontrasting

confidence: 52%

Section: Discussionsupporting

confidence: 46%

Challenges in Management of Bartholin gland Leiomyoma: A Case Report

Vinturache

Ismail

Damato

et al. 2020

Preprint

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“…Even though most of them present with a vulval mass, similarities in HPE make the diagnosis difficult. Differential diagnoses include leiomyoma, haemangioma, PNST, fibroma, angiomyxoma, soft tissue sarcomaand so on 5. Pattern of spindle cell arrangement seen in PNST mimics the smooth muscle arrangement in leiomyoma.…”

Section: Discussionmentioning

confidence: 99%

Recurrent leiomyoma of the vulva mimicking peripheral nerve sheath tumour

et al. 2019

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Leiomyoma, a benign monoclonal tumour, is very rarely found in extrauterine sites, especially in the vulval region. Histopathology of the soft tissue tumours affecting this region is similar and immunohistochemistry (IHC) may be essential to confirm the diagnosis. We report a case of a 63-year-old postmenopausal woman who presented with a recurrent vulval mass involving the clitoris and left labia majora with suspected urethral involvement. Although the wedge biopsy was reported as peripheral nerve sheath tumour, staining with smooth muscle actin clinched the diagnosis of leiomyoma, highlighting the importance of IHC for diagnosis.

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“…2 This case is unique as fewer than 160 cases of smooth muscle tumours of the vulva have been reported in the literature. [2][3][4][5] Differentiating leiomyoma from atypical leiomyoma and leiomyosarcoma is challenging. Tavassoli and Norris have proposed the following diagnostic criteria for leiomyosarcoma: 9 • More than 5 cm in greatest dimension • Infiltrative margins • More than 5 mitotic figures per 10 HPF Nielsen et al studied clinicopathological features of 25 cases of smooth muscle tumours of vulva comprising of leiomyoma and five leiomyosarcoma.…”

Section: Discussionmentioning

confidence: 99%

“…1 In literature there are limited reports of Leiomyoma vulva. [2][3][4][5] Identifying leiomyosarcoma in this region is difficult. It is important to diagnose malignancy due to the risk of recurrence as patients may need radiation and/or chemotherapy in addition to wide local excision and appropriate follow up.…”

Section: Introductionmentioning

confidence: 99%

Leiomyoma of the vulva: a diagnostic challenge

Saxena

Goel

Sen³

2018

Int J Reprod Contracept Obstet Gynecol

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Smooth muscle tumours of vulva are rare and therefore can be missed clinically. Our patient, 48-year-old lady presented with lump in the left vulva that was clinically diagnosed as Bartholin duct cyst. The lumpectomy was done under local anaesthesia and the lesion was sent for pathological examination. On gross examination the mass was 3.5 cm in diameter. The microscopic examination revealed the lump to be leiomyoma and no necrosis or atypia was present. The final diagnosis of “vulval leiomyoma” was given. Postoperative period was uneventful, and the patient is on regular follow up and there has been no recurrence. Leiomyoma should be kept as a differential diagnosis when a lady presents in late reproductive age group with unilateral swelling in vulvar region which is firm in consistency and the lump must be sent for histopathological examination for definitive diagnosis and rule out malignancy. The pathologists play a critical role in recognition and management of smooth muscle tumors of the vulva and to rule out leiomyosarcoma.

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Differential Diagnosis between Bartholin Cyst and Vulvar Leiomyoma: Case Report

Cited by 11 publications

References 9 publications

Challenges in Management of Bartholin gland Leiomyoma: A Case Report

Challenges in Management of Bartholin gland Leiomyoma: A Case Report

Recurrent leiomyoma of the vulva mimicking peripheral nerve sheath tumour

Leiomyoma of the vulva: a diagnostic challenge

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