Presentation
Keywords Leiomyoma, Swelling, Vulva Case Presentation A 35-year-old patient presented to our department with a history of painless left vulval swelling of over a duration of two years. [clinmedjournals.org]
We present a case of a 46-year-old female that presented to the clinic with 2-year history of right labial mass and was diagnosed as Bartholin cyst initially. The patient underwent elective excision under spinal anaesthesia and the mass was removed. [ncbi.nlm.nih.gov]
On initial presentation most of the vulval leiomyoma are usually misdiagnosed as Bartholin’s cyst or abscess [2–4]. Nielsen et al. studied 25 cases of leiomyoma of vulva. [hindawi.com]
The main presenting symptoms were discharge associated with minimal bleeding, and a lateral vaginal wall mass that had been present for the previous eight months and had been increasing in size. [tandfonline.com]
Entire Body System
- Inflammation
Local examination revealed a labial swelling on the left side with signs of inflammation. Diagnosis of Bartholin’s abscess was made and she was started on parenteral antibiotics. Within 24 hours her pain decreased and inflammation subsided. [hindawi.com]
Local examination Showed enlarged left side vulval swelling 12 × 10 cm, firm, fairly mobile with no tenderness and no signs of inflammation (Figure 1). The uterus was of normal size and there was no adnexal mass. [clinmedjournals.org]
Skin
- Erythema
As the swelling increases in size patients started to experience symptoms such as pain, itching and erythema [5,6]. The patient in index was asymptomatic for 2 years and she did not seek any medical advice until she started to experience discomfort. [clinmedjournals.org]
Most patients in their series presented with a painless mass, other symptoms being pain, itching, and erythema. Most common preoperative diagnosis was Bartholin’s gland cyst. There were 20 leiomyoma (4 atypical) and 5 leiomyosarcoma. [hindawi.com]
Neurologic
- Confusion
Distinguishing between benign and malignant forms is also confusing, which makes vulvar leiomyoma a great diagnostic challenge. [ncbi.nlm.nih.gov]
Urogenital
- Adnexal Mass
The uterus was of normal size and there was no adnexal mass. Abdominal, transvaginal and transperineal scan revealed a cystic swelling in the left vulva with degenerative changes. No other pathology was detected in the scan. [clinmedjournals.org]
Treatment
Thus, treatment with receptor modulators in adjuvant to surgery may be beneficial [3, 7]. [ncbi.nlm.nih.gov]
Histologic evaluation confirms the diagnosis and guides the need for further treatment. [tandfonline.com]
Surgical excision of the tumour along with some of the surrounding tissues is the treatment of choice of vulval leiomyoma [1,3,4]. [clinmedjournals.org]
Surgical excision is the treatment. (a) Bartholin’s cyst (b) Our case: vulval leiomyoma Leiomyoma or fibroid though very commonly seen in the uterus is a rare entity in vulva, ovaries, urethra, and urinary bladder. [hindawi.com]
Prognosis
These lesions need to be surgically excised, and the prognosis is good if they are completely removed.14 Close long-term follow-up is required because of the high risk of recurrence,8 but no recurrence was observed after one year of follow-up in this [febrasgo.org.br]
Pathophysiology
Sun C, Zou J, Wang Q, Wang Q, Han L, et al. (2018) Review of the pathophysiology, diagnosis, and therapy of vulvar leiomyoma, a rare gynecological tumor. J Int Med Res 46: 663-674. [clinmedjournals.org]
Prevention
Complete excision was possible, with careful dissection in the posterior-medial border of the tumour from the anal sphincter to prevent damage. The defect was closed in layers to obliterate dead space and a good anatomical repair was achieved. [tandfonline.com]