Pelvic Myxoid Leiomyoma Mass between Vagina and Rectum

Abstract

Leiomyomas are the most common pelvic tumors in women. About 20–30% of women older than 35 are affected. Rare conditions of leiomyomas have extrauterine locations. Myxoid degeneration is a rare type of leiomyoma degeneration. We report a case of solid-cystic myxoid leiomyoma in a 53-year-old woman complained of constipation, urinary hesitation, and malodorous vaginal discharge with palpable 17 × 12 cm mass between vagina and rectum. Regarding the inferior location of the mass, a perineal approach was used to enucleate it. This rare location has not been mentioned before. The woman was finally diagnosed by pathologists which was myxoid leiomyoma.

Extra-Uterine Leiomyoma Presenting After Hysterectomy

“…Leiomyomas are a common gynaecological finding affecting 20-30% of women over the age of 35, with prevalence decreasing following menopause [1,3]. Around 25% of women present clinically with a leiomyoma, which is most commonly found within the uterus [2].…”

“…Around 25% of women present clinically with a leiomyoma, which is most commonly found within the uterus [2]. Rarer extra-uterine locations include the broad ligament, cervix, and vagina [3]. Uncommon manifestations of leiomyoma include intravenous leiomyomatosis, parasitic leiomyoma, and benign metastasizing leiomyoma [2].…”

“…Ultrasound provides a fast method in detailing the size, site, and number of uterine fibroids. Magnetic resonance imaging (MRI) is utilized to evaluate the leiomyoma in relation to the rest of the pelvis, including relations to neurovascular structures and nearby organs [3]. The use of MRI as in our case can assist in the planning of operative management.…”

“…The use of MRI as in our case can assist in the planning of operative management. However, imaging methods are not reliable in determining the probability of malignant transformation which is reserved for histological evaluation [3].…”

“…Around 25% of women present clinically with a leiomyoma, which is most commonly found within the uterus [2]. Rarer extrauterine locations include the broad ligament, cervix, and vagina [3]. We present a rare case of an extrauterine leiomyoma located in the perineum of a 59-year-old female.…”