Obstet Gynecol Sci.  2014 Nov;57(6):560-563. 10.5468/ogs.2014.57.6.560.

Necrotizing ruptured vaginal leiomyoma mimicking a malignant neoplasm

• Sim CH
• Lee JH
• Kwak JS
• Song SH

• KMID: 2314029
• DOI: http://doi.org/10.5468/ogs.2014.57.6.560

Abstract

Leiomyomas are common benign uterine tumors. However, the incidence of vaginal myoma is very rare and may be confused with a variety of vaginal tumors. We report a case of 43-year-old nulligravida who presented with a protruding painful vaginal mass for 7 days. The mass had initially appeared 3 years prior, as 2 to 3 cm that had not subsequently increased. However suddenly, there was rapid severe enlargement over the course of 7 days. Physical exam revealed a monstrous shaped, black color with focal necrosis, odorous protruding vaginal mass about 7 cm in size. The vaginal mass was infected and degenerated. And vaginal wall was also destroyed by the enlarged mass. Because of the clinical features and radiologic findings, the preoperative diagnosis was a vaginal malignancy. We reported an extremely rare case of vaginal myoma that had several characteristics of malignancy, with a brief review of the literature.

Keyword

Myoma; Paraurethral mass; Ruptured vaginal leiomyoma; Vaginal malignancy

MeSH Terms

Adult
Diagnosis
Humans
Incidence
Leiomyoma*
Myoma
Necrosis
Odors

Figure

• 

  Fig. 1 (A) An irregular shaped tender protruding vaginal mass, black color with multiple focal necrosis, was found. The vagina mucosa was broken (arrows). (B) The high power photogram demonstrated the bundles of spindle cells interlacing in right angle. There was less than 2 mitotic figure (H&E, ×200).

• 

  Fig. 2 Vaginal mass in a 43-year-old woman. (A) T2-weighted axial magnetic resonance (MR) image shows irregular shaped mass (arrow) in the vagina. The signal intensity of the mass is heterogenous and higher compared that of pelvic muscle. (B) T1-weighted axial MR image. The signal intensity of the mass (arrow) is similar to that of pelvic muscle. (C) The mass (arrow) has heterogenous high signal intensity on T2-weighted sagittal MR image. (D) The mass (arrow) has irregular enhancement on contrast enhanced T1-weighted MR image

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