Leiomyoma of levator ani muscle

Abstract

Epithelioid leiomyomas of the vagina are extremely rare benign smooth muscle tumors. Leiomyomas are located in uterus in 70%; however, paravaginal leiomyomas are rare, which frequency is 0.1% in adults women. They can be asymptomatic, but if they are, may cause signs of compression, dyspareunia, urinary disorders,… The diagnosis is made by histologic and immunohistochemical examination, helped by imaging tests such as RMN and ultrasound. The first treatment option is the resection by enucleation. Search of information was carried out in the PubMed/Medline, Cochrane, SciELO databases and references from articles in journals and recent published texts. This is a case report of a 29-years-old female who is derived to Gynecologic Emergencies because of a Bartholinitis refractory to antibiotic treatment. The gynecological exploration reports a vaginal mass which extends to left paravaginal space. The biopsy of this mass suggests the diagnosis of leiomyoma. MRI study reports a 49mm mass in left ischiorectal space which seems to depend on puborectal muscle. The resection is made by enucleation, with a histopathological examination that confirms the diagnostic suspicion.