Leiomyoma of the Vulva: A Diagnostic Challenge Case Report

Vulvar Leiomyoma Masquerading as Bartholin Cyst: A Case Report of Unveiled Diagnosis and Surgical Management

Vulvar leiomyomas are rare benign tumors originating from smooth muscle cells of the vulvar tissue. We present the case of a 44-year-old female patient complaining of a painless vulval mass for 12 years, gradually increasing from 1x1 cm to 5x4 cm. Clinical assessment initially suggested a Bartholin cyst because of its non-tender and non-fluctuant nature. However, surgical intervention revealed an unexpected diagnosis of vulvar leiomyoma, measuring 5x5x4 cm. The patient underwent successful excision and repair under spinal anesthesia. This case underscores the significance of meticulous clinical evaluation and accurate histopathological examination in distinguishing vulvar masses. Accurate diagnosis guides appropriate management, and long-term follow-up prevents complications and recurrence. This report highlights the diagnostic challenges of rare vulvar lesions and the importance of a comprehensive approach to their evaluation and treatment.

A Case Report of Vulvar Leiomyoma: A Rare Pathological Entity

Smooth muscle tumors, known as leiomyomas, are benign and can grow anywhere in the body, but the uterine myometrium is the most common site. Vulvar leiomyomas are uncommon and rare. We report a case of a 25-year-old female P (para) 1 L (live) 1 with a previous normal vaginal delivery, who presented two painless swelling of in vulva for one year. The urethral meatus deviated to the left side. After surgical excision, a histopathological examination was performed that confirmed leiomyoma. The patient was discharged after an uneventful postoperative period. A vulvar leiomyoma tumor is often mistaken for a Bartholin cyst, and it is challenging to distinguish between benign and malignant types of vulvar leiomyomas, making diagnosis extremely challenging.

Unusual Vulvar, Perineal, and Uterine Leiomyomas: A Case Report

Vulvar leiomyomas are extremely rare smooth muscle tumors that are easily mistaken for other lesions, as the differential diagnosis must consider a wide spectrum of benign and malignant lesions. We present the case of a 52-year-old woman with a three-year history of progressive abdominal distension and pain and an enlarging vulvar mass distorting the labia majora and causing gait disturbance. Imaging confirmed an enormous pelvic mass originating in the uterus, compatible with a leiomyoma/sarcoma, and large perineal and vulvar masses with similar characteristics. Histopathology after surgical removal revealed benign abdominal, vulvar, and perineal leiomyomas. This case highlights the rarity and diagnostic challenges of extra-uterine leiomyomas, particularly those in the vulvar region.

Vulvar leiomyoma in an adolescent girl: a case report and review of the literature

BACKGROUND

Vulvar leiomyoma is a rare soft tissue tumor, with only around 300 cases described in the literature. Owing to its low incidence of just 0.03% of all gynecological tumors, it often poses a great diagnostic challenge, especially in teenagers. We report this rare occurrence of vulvar leiomyoma in a teenage girl who was primarily left untreated due to cultural taboos and fear of loss of virginity. The main aim in presenting such rare case studies is to raise awareness and expand the diagnostic horizon of the surgeon for appropriate management.

CASE PRESENTATION

We describe a case of a 15-year-old North Indian, sexually inactive unmarried girl, who presented with a history of painless swelling in the left labia majora for the last 1 year, which gradually increased in size. There was no associated pain or any other difficulty. Local examination revealed a 14 × 10 cm solid, unilateral nonpedunculated mass on the left labia majora with superficial vascularity. Differential diagnoses of sarcoma, lipoma, Bartholin cyst, and fibroid were kept in mind. Ultrasonography revealed a solid mass with superficial vascularity with normal internal genitalia. The mass was enucleated with an intact capsule under anesthesia. Histopathology confirmed it to be benign vulvar leiomyoma. The patient was discharged after 3 days in a satisfactory condition.

CONCLUSION

Leiomyoma of the vulva is an exceptionally rare tumor and is seldom seen in teenagers. It is often misinterpreted as a Bartholin cyst and should be kept as one of the differential diagnosis in teenage girls presenting with unilateral vulvar swelling. Vulvar leiomyoma can be completely cured by surgical removal if diagnosed timely without compromising virginity, so should never be missed in adolescents.

Vulvar leiomyoma: a case report

Leiomyomas represent about 3.8% of all benign soft tissue tumors. Vulvar localization is very rare. We present a case of a vulvar leiomyoma and discuss diagnostic and therapeutic features of this disease. A 30-year-old female patient with no medical history, had a 5cm mass located in the left large lip causing a discomfort at the perineum especially in sitting and walking. She underwent a complete surgical excision of the mass. The pathological examination confirmed the diagnosis of a leiomyoma. There was no recurrence after 24-months' follow-up. The vulvar leiomyoma is a rare benign tumor. The diagnosis is made only postoperatively after resection of the mass. The treatment is essentially based on total excision of the mass with a good prognosis.