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

Abstract

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.

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

“…Leiomyomas are most often found in the uterus, with extra-uterine locations being rare. Vulvar leiomyomas account for only 0.03% of all gynecologic neoplasms and 0.07% of all vulvar tumors, with only about 300 cases described in the literature [2][3][4].…”

“…Most patients present with a long history of a painless mass that can sometimes compress the urinary bladder and rectum [3]. As the mass increases, patients can experience difficulty walking, sitting, or having intercourse.…”

“…Histopathological examination is the only accurate way to verify benignity and to rule out the presence of other kinds of mesenchymal vulval tumors, which can exhibit aggressive behavior [3,7]. Histologically, leiomyomas are circumscribed masses with spindle cells and myxoid stroma.…”

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

“…Misdiagnosing a vulvar leiomyoma as a Bartholin cyst can lead to unnecessary interventions or inadequate treatment. Therefore, the differentiation between these entities is essential to offer tailored and effective care [7].…”

Vulvar leiomyoma

“…Leiomyom kan oppstå i alt vev med glatt muskulatur, men er vanligst i livmoren. Leiomyom i vulva oppstår oftest i labia majora og klitoris (2). Bartholincyster og abscesser er langt mer vanlige årsaker til oppfylning i vulva (3), og leiomyom baktil i labia majora, slik vår pasient hadde, vil derfor ofte bli feildiagnostisert som dette.…”