Leiomyoma of the Vulva

A rare case of benign vulvovaginal leiomyoma: Case report and literature review

“…One case even died of a leiomyosarcoma of the vulva [ 17 ]. Therefore, it is recommended to surgically remove any vulval mass for proper histological and immunological examination [ [8] , [9] , [10] , [17] , [18] , [19] , [20] ]. This should be performed after proper ultrasonographic examination or even magnetic resonance imaging to determine preoperative soft tissue invasion [ 18 ] and to differentiate between a Bartholin gland cyst and a leiomyoma [ 7 ].…”

Vulvar Leiomyoma Presenting as a Painless Vulvar Mass

“…Diagnosis of vulvar masses may include imaging to determine their extent and vascularity. MRI may have a beneficial role in diagnosing vulvar leiomyomas because of the low signal intensity suggesting smooth muscle on T2-weighted images [1,2,6].…”

“…They typically present as a painless, solitary, wellcircumscribed tumor and have been reported in patients between 15 to 73 years of age [2]. Although the histogenesis is unclear, lesions may arise from smooth muscle cells within erectile tissues, blood vessel walls, and the round ligament [1,[5][6]. Typical vulvar leiomyomas demonstrate spindle-shaped cells, but other histological variants such as epithelioid and myxoid tumors have also been reported [2,4].…”

“…Immunohistochemistry tends to stain positive for anti-smooth muscle antibody, desmin, and vimentin, aiding diagnosis in this case [4]. They may also stain positive for estrogen and/or progesterone [1,4,6]. A vulvar leiomyosarcoma may be suggested if three of the following criteria are met: size of 5 cm or more, infiltrative margins, 5 or more mitotic figures per 10 high power fields, and grade 2 to 3 atypia [1,[4][5][6].…”

“…They may also stain positive for estrogen and/or progesterone [1,4,6]. A vulvar leiomyosarcoma may be suggested if three of the following criteria are met: size of 5 cm or more, infiltrative margins, 5 or more mitotic figures per 10 high power fields, and grade 2 to 3 atypia [1,[4][5][6]. Additional treatment is required for this presentation [1].…”