Background:

Vaginal leiomyomas are exceptional tumours. Only 330 cases have been reported in the world literature.

Clinical case:

Patient of 37 years old, with a vagina tumour of rapid growth. The physical examination showed a mass of hard consistency, without pain on palpation, of approximately 30 mm in average diameter, in the lower third of the right lateral of the vagina, compatible with the vaginal myoma. At that time the patient refused to receive treatment. After a few months, a consultation for vaginal discomfort, metrorragia greater than the menstrual cycle and dyspareunia. Ultrasonography and magnetic resonance showed a tumour that increased in size (58 x 57 x 60 mm), had a rounded shape and a solid appearance, located in the vesicovaginal space. With these data the diagnosis of pediculated vaginal leiomyoma was established. Ulipristal acetate (5 mg / day) was prescribed to decrease volume and myomatous bleeding. After two treatment cycles, an increase in the tumour was observed, which reached a size of 70 x 55 mm. It was decided to perform myomectomy vaginally, without objectifying the pedicle dependent on the uterus and the cervix. The postoperative period was uneventful. The histopathological study confirms the diagnosis of vaginal leiomyoma.

Conclusion:

The signs and symptoms (bleeding or abnormal staining, vaginal discharge, pain or pelvic mass) of the extrauterine leiomyosarcomas make it difficult to establish precise recommendations to establish the diagnosis and treatment.