What is this vaginal bulge? An atypical case of vaginal paraurethral leiomyoma. A case report and literature systematic review - 12/05/21

Doi : 10.1016/j.jogoh.2020.101822

Andrea Braga ^a,^⁎ , Ilaria Soave ^a,^b, Giorgio Caccia ^a, Luca Regusci ^a, Giovanni Ruggeri ^a, Ilvana Pitaku ^a, Valerio Bassi ^a, Andrea Papadia ^c, Maurizio Serati ^d
^a Department of Obstetrics and Gynecology, EOC - Beata Vergine Hospital, Mendrisio, Switzerland
^b Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea Hospital, University of Rome “Sapienza”, Rome, Italy
^c Department of Obstetrics and Gynecology, EOC - Civico Hospital, Università della Svizzera Italiana, Lugano, Switzerland
^d Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, Varese, Italy

^⁎Corresponding author at: Dept. Obstetrics and Gynaecology, EOC - Beata Vergine Hospital, Via Turconi 23 CP 1652, 6850 Mendrisio, Switzerland.Dept. Obstetrics and GynaecologyEOC - Beata Vergine HospitalVia Turconi 23 CP 1652Mendrisio6850Switzerland

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Highlights

•	Vaginal paraurethral leiomyomas are uncommon benign tumors of the female genitourinary tract.
•	The recurrence and transformation into malignant condition are rare.
•	Diagnosis is based on histopathological examination; MRI and US can be useful to define the size and localization.
•	Management requires surgical vaginal excision; however, abdominal approach could be considered.

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Abstract

Aim

Vaginal paraurethral leiomyomas are uncommon benign tumors of the female genitourinary tract. We report a case of anterior vaginal paraurethral leiomyoma. Furthermore, we performed a systematic review of the literature to provide information that can help the physicians in the diagnosis and management of women with this rare pathology.

Methods

A case of anterior vaginal paraurethral leiomyoma in 53-year-old, primiparous, caucasian woman with history of pelvic pressure, vaginal bulging and overactive bladder symptoms, was described. Furthermore, a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was performed between January 1, 2000 to Dec 30, 2019. Only articles that reported cases of vaginal or paraurethral leiomyoma (b) case series and case reports with literature review were included.

Results

we screened a total 2281 records; 70 articles published from 2000 to 2019 were included.

Conclusion

Vaginal paraurethral leiomyoma is a rare benign tumor of the vagina with a wide spectrum of symptoms and good prognosis. The recurrence and transformation into malignant condition are rare. Histopathological examination is the gold standard for diagnosis, but MRI and US can be help to define the size and localization of the tumor. Management requires surgical vaginal excision in the majority of cases; however, abdominal approach could be considered when it is large and located high in the vagina.

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Keywords : Benign tumor, Fibroid, Leiomyoma, Paraurethral, Vagina