Case of a Vulvar Leiomyoma

Uterine leiomyomas affect nearly 30% of women more than 35 years of age. However, vulvar leiomyomas are rare and often misdiagnosed as Bartholin cyst preoperatively. These tumors involve smooth muscles and are generally painless, solitary, and well-circumscribed, which may affect women of any age group. 

A report describes a case of a 46-year-old female who presented with a 2-year history of right labial mass. The mass was mildly progressive and painful. No history of discharge, fever, or weight loss was present. No abnormality was detected on general examination except for a soft mass that measured 4 × 3 cm and was present medial to the right labia minora. She gave a history of four spontaneous vaginal deliveries without induction, and her family history was unremarkable.

The mass was initially diagnosed as a Bartholin cyst, for which she agreed to undergo surgical intervention and was booked for daycare surgery. An elective excision under spinal anesthesia with performed, where the incision at the mucocutaneous junction displayed a soft, fleshy, and well-defined mass measuring 3 × 4 cm, which was later sent to the histopathology lab. 

She had a good recovery postoperatively without any complications.

Histopathological examination revealed the gross specimen to consist of two soft pieces of tissue measuring 4.1 × 2.3 × 1.8 cm, which on slicing demonstrated a fleshy solid cut surface without any cyst. Microscopy revealed benign tumor containing sheets and fascicles of an oval to spindle-shaped cells with abundant dense cytoplasm and areas of hyalinization, hence the final diagnosis was given as benign vulvar leiomyoma.

SOURCE- Kurdi S, Arafat AS, Almegbel M, Aladham M. Leiomyoma of the Vulva: A Diagnostic Challenge Case Report. Case Rep Obstet Gynecol. 2016;2016:8780764. doi:10.1155/2016/8780764