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LETTER TO EDITOR Table of Contents   
Year : 1999  |  Volume : 9  |  Issue : 3  |  Page : 156-157
Leiomyoma of the vagina


Department of Radiology, My Hospital, Indore, India

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How to cite this article:
Tiwari O P, Gupta A, Gupta M. Leiomyoma of the vagina. Indian J Radiol Imaging 1999;9:156-7

How to cite this URL:
Tiwari O P, Gupta A, Gupta M. Leiomyoma of the vagina. Indian J Radiol Imaging [serial online] 1999 [cited 2019 Jul 21];9:156-7. Available from: http://www.ijri.org/text.asp?1999/9/3/156/28329
Sir,

We wish to report a case of leiomyoma of the vagina.

A thirty-five years old woman with a history of two earlier Cesarean sections reported with complaints of pain and heaviness in the lower abdomen which was more on the right side and with occasional white discharge.

Per speculum and per-vaginal examination revealed vaginitis and a white discharge. A large swelling, predominantly cystic was felt through the anterior vaginal wall. The cervix could not be seen clearly and only a small part of the cervix was felt posteriorly. On US, the uterus and ovaries were of normal size. A large, slightly hypoechoic, well defined, rounded mass 7.5 x 6.3 x 6.6 cm. in size was observed in the vaginal area, sparing the cervix. The bladder wall was indented posteriorly by the lesion. There was an ill defined hypoechoic area in the upper part representing necrosis [Figure - 1],[Figure - 2]. A laparotomy was performed and a mass was found three inches below the cervix originating in the anterior vaginal wall. Histopathology revealed a vaginal leiomyoma.

Myomas represents the most frequent gynecological tumor. About 20% of all women after the age of 35 years develop myomas [2]. The majority of myomas arise in the uterus, but they can arise from other extrauterine sites such as the  Fallopian tube More Detailss, cervix, vagina [1], [8] round ligament, ovary uterosacral ligament, urethra [7]. The US appearance of a leiomyoma depends on the ratio of fibrous tissue to smooth muscle, the extent of degeneration and presence or absence of calcification.

Avaginal leiomyoma is a rare entity [4],[5] and is normally benign. Patients are asymptomatic in the early stages. Symptoms arise due to compression from the growing tumor. Low back pain occurs due to pressure on the pelvic ligaments or lumbar plexus and dysuria due to pressure on the urinary bladder. Most leiomyomas are not diagnosed clinically but only on histological examination [1]. Reported vaginal leiomyomas were found originating from the anterior vaginal wall [1]

Macroscopically the tumor on cut section is white to tan with a whorled appearance. As myomas exhibit growth, they also risk diminution of the blood supply giving rise to a series of degenerative changes, which alter their gross and microscopic appearances.

Microscopically, these tumors consist of fascicles of uniform smooth muscle cells. The cells have a typical spindle configuration with indistinct cell borders and abundant pale eosinophilic cytoplasm. Usually with large tumors, cystic degeneration occurs, visualized as watery fluid in the interstitium. Recurrence after removal is extremely rare [1],[3].

 
   References Top

1.Nel CP, Tiltman AJ. Eight cases of leiomyoma of vagina. S Afr Med J 1978; 11: 54: 816 -817.   Back to cited text no. 1    
2.Shaw's Text Book of Gynaecology. 10th ed. 1989; 143, 402.   Back to cited text no. 2    
3.Dhaliwal LK, Das I, Gopalan S. Recurrent leiomyoma of vagina. Int J Gynaecol Obstet 1992; 37: 281-283.   Back to cited text no. 3  [PUBMED]  
4.Vaginal leiomyoma: The female prostrate. Acta Urol Belg 1993; 61:31-32.   Back to cited text no. 4    
5.Callen. Ultrasonography in obstetrics and gynaecology. 3rd ed. 1994; 603.   Back to cited text no. 5    
6.Ruggieri AM, Brody JM, Curhan RP. Vaginal leiomyoma: A case report with imaging findings. J Reprod Med 1996; 41: 875-877.   Back to cited text no. 6  [PUBMED]  
7.Gut R, Wozniak F, Listos T. A rare case of ovarian leiomyoma. Ginekol Pol 1997; 68: 567-571.   Back to cited text no. 7  [PUBMED]  
8.Hazra PC, Singhal S, Dahiya P, Sangwan K: Leiomyoma of vagina: J. Indian Med. Association 1998; 20: 60-61.   Back to cited text no. 8    

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Correspondence Address:
O P Tiwari
Department of Radiology, My Hospital, Indore
India
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Source of Support: None, Conflict of Interest: None


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