Leiomyoma of the Vulva: A Diagnostic Challenge Case Report

Abstract

Uterine leiomyomas are common and can affect up to 30% of women older than 35 years. Despite this, leiomyomas of the vulva are rare, masquerading, and usually misdiagnosed as Bartholin cyst preoperatively. These smooth muscle tumors are typically painless, solitary, and well circumscribed and can affect female of any age group. We present a case of a 46-year-old female that presented to the clinic with 2-year history of right labial mass and was diagnosed as Bartholin cyst initially. The patient underwent elective excision under spinal anaesthesia and the mass was removed. The final diagnosis after microscopy result showed benign vulvar leiomyoma.

Vulvar leiomyoma: a case report

“…Their etiology is still poorly understood, but it is likely that estrogens and progesterone are involved in tumor proliferation, as long as fibroids rarely appear before menarche and often regress after menopause [4]. Immunohistochemical analysis-when performed-reveals estrogen and/or progesterone receptors [1]. Several ectopic localizations have been reported in the literature: vulva, ovaries, urethra, bladder, peritoneum and retroperitoneum [5].…”

“…Vulvar leiomyomas are particularly rare. To our knowledge, only 160 cases have been reported in the literature [1]. Reidel et al found a single fibroid after examining 144 vulvar tumors [6].…”

“…Preoperative diagnosis can be difficult because of the rarity of this tumor and the non-specific clinical presentation. In preoperative, it is confused with the cyst of Bartholin or even a bartholinitis [1]. Clinical presentation varies.…”

“…Leiomyomas represent about 3.8% of all benign soft tissue tumors [1]. They can develop anywhere in the body where smooth muscle is present.…”

Leiomyoma of the Vulva

“…Ultrasound is the most reliable imaging tool in establishing the diagnosis of uterine and extrauterine leiomyoma [5,12]. Magnetic resonance imaging (MRI) is useful in differentiating benign and malignant lesions in difficult cases [4,5]. A characteristic feature of malignant lesions on MRI is low signal intensity on T2-weighted images [1].…”