Vulvar Leiomyoma Presenting as a Painless Vulvar Mass

Abstract

A 21-year-old woman with a painless 3-cm vulvar mass underneath the right labia minora (Fig. 1) had both a translabial ultrasound (Fig. 2A) and magnetic resonance imaging (Fig. 2B) that demonstrated a well-circumscribed, vascular nodule. A fine needle biopsy was not considered because of its vascular nature. The patient underwent excision of the lesion with an epithelioid leiomyoma of the vulva confirmed histologically (Fig. 3). Fig. 2Imaging. (A) Ultrasound image with color doppler showing border (yellow triangles) and vascular nature of vulvar leiomyoma. (B) Sagittal T2-weighted magnetic resonance image of vulvar leiomyoma (yellow circle). Pubic symphysis (PS) and uterus (UT) labeled for orientation. View Large Image Figure Viewer Download Hi-res image Fig. 3Histology of specimen. (A) Moderate cellular proliferation of epithelioid cells arranged in fascicles and vague nests with some areas showing a watered silk pattern (magnification: 10×). (B) Cells have bland, uniform, round to oval nuclei with ill-defined eosinophilic cytoplasm with virtually no mitotic activity or nuclear pleomorphisms (magnification: 40×). (C) Tumor cells show diffuse staining with smooth muscle actin (magnification: 10×). Images courtesy of Dr. Michelle Meyer. View Large Image Figure Viewer Download Hi-res image