Leiomyoma of the vulva: a diagnostic challenge
Keywords:Bartholin cyst, Leiomyoma, Vulva
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.
Fasih N, Shanbhogue PAK, Macdonald DB, Fraser-Hill MA, Papadatos D, Kielar AZ, et al. Leiomyomas beyond the uterus: unusual locations, rare manifestations. Radiograph. 2008;28(7):1931-48.
Levy RA, Winham WM, Bryant CS, Quick CM. Smooth muscle neoplasms of the vulva masquerading as Bartholin gland duct cysts. Proc (Bayl Univ Med Cent). 2014;27(1):25-7.
Tavares KADS, Moscovitz T, Tcherniakovsky M, Pompei LM, Fernandes CE. Differential diagnosis between bartholin cyst and vulvar leiomyoma: case report. Rev Bras Ginecol Obstet. 2017;39(8):433-5.
Reyad MM, Gazvani MR, Khine MM. A rare case of primary leiomyoma of the vulva. J Obstet Gynaecol. 2006;26(1):73-4.
Pandey D, Shetty J, Saxena A, Srilatha PS. Leiomyoma in vulva: a diagnostic dilemma. Case Rep Obstet Gynecol. 2014:386432.
Misumi S, Irie T, Fukuda K, Tada S, Hosomura Y. A case of deep soft tissue leiomyoma: CT and MRI findings. Radiat Med. 2000;18(4):253-6.
Kumar V. The female genital tract. In: Kumar V, Abbas AK, Fausto N, Aster J, eds. Robbins and Cotran Pathologic Basis of Disease. Philadelphia: Saunders Elsevier; 2010:1005-62.
Kaufman RH, Gardner HL. Benign mesodermal tumors. Clin Obstet Gynecol. 1965;8(4):953-81.
Tavassoli FA, Norris HJ. Smooth muscle tumors of the vulva. Obstet Gynecol. 1979;53(2):213-7.
Nielsen GP, Rosenberg AE, Koerner FC, Young RH, Scully RE. Smooth-muscle tumors of the vulva: a clinicopathological study of 25 cases and review of the literature. Am J Surg Pathol. 1996;20(7):779-93.
Nucci MR, Fletcher CD. Vulvovaginal soft tissue tumours: update and review. Histopathol. 2000;36:97-108.
Losch A, Joura EA, Stani J, Breitenecker G, Lahodny J. Leiomyosarcoma of the vulva: a case report. J Reprod Med. 2001;46:609-12.