Vaginal Leiomyoma Research Articles

Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) as Treatment for Upper Vaginal Leiomyoma

Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) as Treatment for Upper Vaginal Leiomyoma

Vaginal leiomyoma in a goat expressing the nuclear progesterone receptor (PGR): a case report

BackgroundThe risk of developing tumorous diseases in the genital tract also increases with age in animals. One of the classified tumor types is genital leiomyoma. Presently, our understanding of the pathogenesis of this tumor in goats is, however, limited. This accounts also for the information regarding the presence of steroid hormone receptors and, thus, possible responsiveness to circulating steroids.Case presentationThis study describes the case of a vaginal tumor in a seven-year-old Anglo-Nubian goat. The goat was presented due to blood mixed vaginal discharge. Per vaginal examination a singular pedunculated mass in the dorsum of the vagina measuring approximately 3 cm x 4 cm x 4 cm was revealed. After administering epidural anesthesia, the mass was removed electrothermally. There were no postoperative complications. The histopathological examination identified the mass as a leiomyoma. The immunohistochemical examination revealed the presence of the nuclear progesterone receptor (PGR) in the tumor tissue. One year after the surgery, during the follow-up examination, the goat was in good overall health, and the owners had not observed any recurrence of vaginal discharge.ConclusionsWhen observing vaginal discharge in goats, it is important to consider the possibility of genital tract tumors. These tumors may express sex steroid receptors. In the future, it is worth considering the investigation of potential approaches for preventing tumorigenesis or treating the tumor, such as castration or the administration of antiprogestogens.

Early diagnosis and appropriate management of vaginal leiomyoma in rural areas

HIGHLIGHTS Extrauterine leiomyoma, including vaginal leiomyoma, is an exceedingly rare condition with complex pathogenesis and management Clinical evaluation and high-quality imaging are required to confirm the diagnosis of vaginal tumor. If there are insufficient facilities, referrals must be made. Operative management using vaginal approach was described for treating vaginal leiomyoma. ABSTRACT Objective: To describe the challenges of early diagnosis and appropriate management of vaginal leiomyoma in rural areas. Case Report: A 26-year-old woman, P1A0, was referred from a rural hospital and presented a chief complaint of vaginal mass. The patient was admitted to the tertiary hospital with suspected malignant vaginal tumor and underwent a biopsy, which revealed leiomyoma on pathological examination. Despite conservative treatment, the mass continued to grow, unaffected by the menstrual cycle, causing discomfort. Following a second hospital admission, the patient underwent surgical management of extirpation and vaginal reconstruction. The microscopic finding of the tumor showed myositis cell proliferation with hyperplastic growth, monotonous nuclei, and variable cell shapes, supporting the diagnosis of vaginal leiomyoma. During postoperative monitoring, there was no vaginal bleeding. Thereafter, on the day following surgery, it was found that the right labium major was swollen. This was treated with anticoagulants, topical NSAIDs, and a sitz bath. The patient was discharged from the hospital in good condition and had an uneventful postoperative recovery. Conclusion: Although the incidence of vaginal leiomyoma is uncommon, precise early diagnosis and appropriate management might improve outcomes, particularly in rural areas.

Transvaginal excision of vaginal paraurethral leiomyoma: A video case report

Introduction and hypothesisVaginal leiomyomas are uncommon benign tumors of the genital district that appear as a circumscribed, mobile, and nontender mass along the vaginal tube. The gold standard of vaginal leiomyoma management is surgical treatment. We aimed to present a clinical case of vaginal leiomyoma successfully treated throughout a transvaginal excision and layered repair. MethodsA 44-year-old woman was referred to our division for vaginal bulging symptoms and dyspareunia. Clinical examination revealed a 4–5 cm hard bulging mass in the anterior vaginal wall, below the urethra, compatible with vaginal leiomyoma. After proper counseling, the patient was admitted to transvaginal leiomyoma excision plus primary layered repair. ResultsNo surgical complications were observed. The indwelling catheter was removed the day after the surgery. The patient was successfully discharged home on postoperative day 1. The patient is currently asymptomatic and there are no signs of recurrence. ConclusionThe procedure was successful in obtaining anatomical repair and relieving symptoms. This approach represents a valid procedure for the surgical management of this uncommon condition.

Successful surgical excision of vaginal leiomyoma in a labrador bitch

Neoplasia of reproductive system in bitch is more common in lower reproductive tract i.e. vagina and vulva, as compare to uterus and ovaries. Majority of the canine vaginal or vulvar neoplasms are leiomyoma, leiomyosarcoma, fibroma and transmissible venereal tumor Vaginal leiomyomas may be single or multiple, intraluminal or extraluminal and usually round or oval, well Defined and encapsulated. Minimum size of excised masses of various sizes was ranging from 0.4 x 0.2 to 2.4 x 2.3 inches and weighing 0.65 to 113 grams, respectively. A case of multiple vaginal leiomyoma that was presented to the department of Veterinary Gynecology, Veterinary College, Gadag, was successfully surgically excised andafter 10 days the bitch was completely recovered from surgical wound and reported.

Vaginal Leiomyomas - Safe Steps for Laparoscopic removal: feasibility from 3 case reports.

Leiomyomas are a common pathology in reproductive-aged women. However, they rarely originate from extrauterine sites. Vaginal leiomyomas constitute a challenging diagnosis, regarding their surgical treatment. Despite the well- established advantages of laparoscopic myomectomy, the efficacy and feasibility of a total laparoscopic approach for such cases has not been yet investigated. To describe step-by-step the laparoscopic technique for vaginal leiomyoma removal (narrated video presentation) and demonstrate the outcomes of a small series managed at our institution. Three patients diagnosed with symptomatic vaginal leiomyomas that presented to our laparoscopic department. Patients aged 29, 35 and 47 years with BMI 20.6 kg/m2, 19.5kg/m2 and 30.1 kg/m2, respectively. Total laparoscopic excision of the vaginal leiomyomas was successful in all three cases without conversion to laparotomy. The technique is demonstrated in a step-by-step video narration. There were no major complications. Average operative time was 146.25 min (range 90- 190 min) and intraoperative blood loss was 120 ml (range 20-300ml). Fertility was preserved in all patients. Laparoscopy is a feasible technique to approach vaginal masses. Further studies are needed to assess safety and efficacy of the laparoscopic technique in such cases.

Leiomiomul vaginal: prezentare de caz şi review narativ

Leiomyoma is one of the most common tumors of mesenchymal origin, being detected in 70% of women of reproductive age. Vaginal leiomyoma (VL) refers to quite rare tumors. To date, about 300 cases of VL have been published in the English language specialized literature. We present the case of a 25-year-old patient, complaining of vaginal discomfort and periodic pains of varying intensity. Ultrasonography examination revealed a 21.9x17.6 mm hypoechoic mass on the anterior vaginal wall, normal-sized uterus, and normal bilateral adnexa. MRI examination determined a 25x18x22 mm isointense solid tumor in the fornix (the left side of the cranial part of the vagina), clearly dissociated from the surrounding tissues. Surgical enucleation was performed. Histopathology testing of the specimen revealed that it was a leiomyoma of the vagina. A clinical examination at a follow-up consultation, after 14 months, showed that her vagina was normal. We also present a brief review of the English language literature on the features of diagnosis and treatment methods for vaginal leiomyoma.

Vaginal Leiomyoma Presenting as Pelvic Organ Prolapse in Pregnancy.

Vaginal leiomyomas are extremely rare in pregnancy. These can present in a variety of ways. They can cause mechanical obstruction leading to maternal and perinatal morbidity. Herein, we describe a patient with a vaginal leiomyoma misdiagnosed and operated as pelvic organ prolapse during the second trimester of pregnancy. She presented with a huge vaginal mass, foul-smelling vaginal discharge, difficulty in urination and defecation and septicemia. On examination, she had a large foul-smelling and necrotic mass protruding from the vagina with urethra lying outside the vagina, and sutures visible just above the mass on the anterior vaginal wall. She was admitted and a lower segment caesarian section was done followed by transvaginal resection of the mass, and cystoscopy was done. Vaginal leiomyomas require surgical removal and it is usually curative and recommended as the initial treatment of choice, especially when the tumour is large enough to cause a potential obstacle to normal labour. Key Words: Vaginal leiomyoma, Pelvic organ prolapse, Pregnancy.

Vaginal Leiomyoma Presenting as Pelvic Organ Prolapse in Pregnancy

Vaginal Leiomyoma Presenting as Pelvic Organ Prolapse in Pregnancy

Gross and histopathological diagnosis of intra-luminal vaginal leiomyoma in an 8-year-old Caucasian bitch: case report

Vaginal leiomyomas are uncommon tumours and they may originate from vaginal smooth muscles, local arterial musculature, bladder or urethral smooth muscles. An 8-year-old Caucasian bitch was presented with a round pendulous smooth solid mass of about 5cm in diameter at the junction between the vestibule and vagina. Two other similar smaller masses were seen on the vaginal wall (0.4-0.6cm in diameter). Histopathologically, abundant densely packed spindle cells of uniform size, indistinct cellular borders, eosinophilic cytoplasm, and elongate, blunt-ended (cigar shaped) nuclei were seen. The cells appeared grouped in broad interlacing fibres at angles of 90 degree in a herringbone pattern, typical of smooth muscle tissue. In-depth examination of the reproductive tract should be carried out to avoid missing valuable diagnostic information that could help in proper intervention.

Laparoscopic Myomectomy of Vaginal Leiomyoma: A Video Case Report

<h3>Study Objective</h3> To demonstrate the surgical steps of a laparoscopic excision of a vaginal leiomyoma. <h3>Design</h3> We present a video of laparoscopic excision of a vaginal myoma. <h3>Setting</h3> Private hospital in Curitiba, Paraná, Brazil. <h3>Patients or Participants</h3> A 45 years-old woman, G2 P2, was referred to our outpatient clinic with a complaint of abdominal pain, frequent urination and nocturia over five months. She underwent vaginal hysterectomy one year earlier due to uterine myoma. On digital examination a round and firm mass was palpable in the left vaginal wall. Magnetic resonance imaging of abdomen and pelvis reported a solid tumor in the left side of vaginal fornix measuring 28 × 26 mm, located 2mm from ureter. The patient underwent a laparoscopic excision of the vaginal tumor. The post-operative histopathology confirmed leiomyoma. <h3>Interventions</h3> A laparoscopic myomectomy was recorded and presented in the video. <h3>Measurements and Main Results</h3> We described the main steps of laparoscopic myomectomy of vaginal leiomyoma. Step 1: Exposure of the operation field. Step 2: Incision and dissection with ultrasonic instrument of visceral peritoneum over the vaginal fornix and towards the rectovaginal space. Step 3: Vaginal opening and excision. Step 4: Dissection towards the leiomyoma to reach the cleavage plane. Step 5: Grasping and traction of the leiomyoma with a traumatic forceps to its enucleation and excision. Step 6: Extraction of leiomyoma through the vagina. Step 7: Vaginal closure with intracorporeal suturing in two layers: first with continuous suture, followed by a second layer with three X stitches of zero poliglecaprone 25. Step 8: Bipolar hemostasis. <h3>Conclusion</h3> The laparoscopic myomectomy of vaginal leiomyoma presented can be an effective and safe treatment due to the advantages of minimally invasive surgery. Our patient was previously hysterectomized, but laparoscopy is a prudent approach as well when necessary to undergo myomectomy of vaginal and uterine fibroids concomitantly.

Rare Vaginal Leiomyoma with Rare Microscopic Findings

Leiomyoma is the most common benign tumor of uterus and rarely may be seen in other parts female reproductive system like the round ligament, utero-sacral ligament, inguinal canal and vagina. Only a few examples of fibroid with vaginal origin have been documented in the literature. With only roughly 300 recorded occurrences, vaginal leiomyomas are still a rare condition. These vaginal fibroids arise most commonly from the anterior vaginal wall causing varied clinical presentations. We report a case of vaginal lateral wall fibroid of 8 cm size and extending into paraurethral space. The vaginal mass was surgically excised and histopathology confirmed the diagnosis of leiomyoma with cartilaginous degeneration.

Computed tomography and magnetic resonance imaging findings in dogs with vaginal leiomyoma and leiomyosarcoma.

In humans, magnetic resonance imaging (MRI) is preferred over computed tomography (CT) for the assessment of pelvic lesions. Although CT findings of several pelvic tumours have been reported in veterinary medicine, MRI findings are limited. The purpose of this study was to retrospectively compare the CT and MRI findings in dogs with vaginal leiomyoma and leiomyosarcoma. This retrospective study of five dogs compared the CT and MRI findings of intrapelvic lesions, including vaginal leiomyoma (n=4) and leiomyosarcoma (n= 1). No invasion of the surrounding tissue was detected on histopathological examination. In this retrospective study, the following parameters of CT and MRI were recorded for each dog: the border between the lesion and the adjacent pelvic organs, including the prostate, rectum or urethra; signal intensity (SI) of the lesion; enhancement pattern; presence of haemorrhage; necrosis or cystic areas and lymphadenopathy. Because SI on MRI is affected by cell density, tumour cell density was analysed using a microscope slide. In vaginal leiomyoma, the border between the lesion and the surrounding pelvic organ tends to be clearer on MRI than on CT. In vaginal leiomyosarcoma, the border was comparable between MRI and CT. Each lesion showed heterogeneous enhancement on CT and MRI scans. In each lesion, the assessment of haemorrhage, necrosis, cystic areas and lymphadenopathy was comparable between MRI and CT. The SI of the lesion on T2WI of the vaginal leiomyoma and leiomyosarcoma were hyperintense in four cases (4/4; 100%) and mixed intense in one case (1/1; 100%), respectively. The cell density of leiomyosarcoma is higher than that of leiomyomas. The SI on T2WI may be useful for differentiating leiomyoma from leiomyosarcoma. MRI may be useful to differentiate vaginal leiomyomas from leiomyosarcomas and evaluate margins.

Clinicopathological evaluation of vaginal leiomyoma and ovarian luteoma in a bitch

A 7-years-old female Golden Retriever dog was presented to the clinic with a multilobular mass protruding from the vulva. On clinical examination, the mass was observed on the circumference of the vaginal canal. The owner reported not noticing a pro-estrous bleeding for a year. On vaginal cytology, parabasal cells, intermediate cells, neutrophil infiltration and clumps of bacteria were determined. Mild anemia, severe leukocytosis and high MPV value were detected. As a treatment, vaginal mass was totally extirpated by partial vaginectomy and subsequently ovariohysterectomy were performed to avoid the re-occurrence of the vaginal tumor. Both vaginal mass and ovariohysterectomy materials were histopatologically examined. Benign tumors were diagnosed which were vaginal leiomyoma and bilateral ovarian luteoma. It was concluded that histopathological analysis of every surgically removed tissue should be performed in order not to miss a tumorous condition even if it does not show any symptoms.

Rare Case of Vaginal Leiomyoma: A Diagnostic Dilemma

Background: Vaginal leiomyoma is an extremely rare benign tumor with only few cases reported so far. It usually arises from smooth muscle cells in sub-epithelial layer of vagina. Its variable presentations can often be confused with other benign or malignant vaginal masses. Case Report: A 40-year-old female, parity 4 living 4, reported to the gynaecology casualty with complaints of frequent menses for 3 years and urinary retention for 2 days. Pelvic examination revealed a mass of around 10×6 cm originating from the left lateral vaginal wall. Histopathological examination of the enucleated mass revealed vaginal leiomyoma. Conclusion: Although vaginal leiomyoma on lateral vaginal wall is a rare entity, it should be included in one of the differential diagnosis of vaginal masses.

CASE REPORT: VAGINAL LEIOMYOMA

Leiomyoma are benign, monoclonal tumors of the smooth muscle cells of the myometrium and contain large aggregations of extracellular matrix composed of collagen, elastin, fibronectin, and proteoglycan. [1] They are the most common benign tumors in females and are most frequently seen in uterus. Vaginal leiomyomas are very rare and often confused with a variety of vaginal tumors. Since the first detected case back in 1733 by Denys de Leyden approximately 300 cases have been reported in the literature so far. [2] They may present with varied symptoms depending on site, size and vascularity including lower abdominal pain, low back pain, vaginal bleeding, dyspareunia and urinary symptoms like frequency, dysuria or other features of urinary obstruction. Here we discuss a case of a 35 year old female who presented to us with complains consistent with prolapse and was provisionally diagnosed as paraurethral vaginal mass which turned out to be vaginal fibroid.

Vaginal leiomyoma mimicking a Cystocele (report case).

Introduction and importanceLeiomyoma, known as a disease of the uterus, composed of spindle-shaped smooth muscle fibers and collagenous stroma, is rarely encountered in other sites especially in the vagina.Case presentationWe report, here, an exceptional case of a vaginal leiomyoma situated in the anterior vaginal wall suggesting in the first place a cystocele. The MRI objectified a rounded formation of the anterior wall of the vagina with regular contours highly suggestive of a vaginal leimyoma. The tumor was surgically removed by the vaginal route. The histopathologic examination confirmed the diagnosis of vaginal leiomyoma.Clinical discussionVaginal leiomyomas are commonly seen in women between the ages of 35 and 50 and are believed to be more common in Caucasian women. Although a rare tumor, vaginal leiomyomas may present with a variety of clinical features and may be mistaken preoperatively for a cystocele, urethrocele, Skene's duct abscess, Gartner's duct cysts, urethral diverticulum, vaginal cysts, cysts Bartholin's gland or a malignant vaginal tumor. The diagnosis is based on careful examination and preoperative imaging (ultrasonography and MRI). Removal of the tumor by vaginal route, wherever possible, with subsequent histopathological examination appears to be the optimum management plan. Although the lesion is benign, local recurrences following incomplete resection and sarcomatous changes have been reported.ConclusionVaginal leiomyoma is a rare benign tumor. The diagnosis is often made only postoperatively after resection of the mass. The tumors may be found in any location within the vagina but are most commonly located on an anterior wall. Imaging can confirm the vaginal origin of the lesion. Surgical excision is the treatment of choice. The diagnosis is based on the histological study of the tumor.

Vaginal leiomyoma misdiagnosed as a Bartholin abscess: A case report from Damascus, Syria

Fibroids are benign neoplasms that are primarily found in the uterus. Fibroids can rarely be found in the vagina—most commonly arising from the anterior wall. Generally, the vagina is an unusual location for tumors. In this article, we present the case of a 30-year-old multigravid Syrian woman presenting to the emergency department with painful swelling of the left labia, mistakenly diagnosed as a Bartholin abscess. A surgical excision was recommended for the solid mass and the mass was sent for histopathological examination which confirmed the diagnosis of a vaginal leiomyoma.

Homeopathic treatment of vaginal leiomyoma in a dog: case report

The most common vaginal neoplasias in old dogs are leiomyoma and fibroma. Although surgical excision is the indicated treatment, it does not eliminate potential complications that may lead to death or poor quality of life. This paper reports the case of a 9 year-old female Doberman dog with vaginal leiomyoma attended by copious and recidivating colporrhagia homeopathically treated between March and December 2005. Homeopathic approach was the one designed at Homeopathic Unit of the Veterinary Hospital, Rural Federal University of Rio de Janeiro, Brazil. The progress of disease was assessed through clinical evaluation, laboratory exams and ultrasonography. Hemorrhage decreased while the general clinical state of the animal improved. After 7 months of homeopathic treatment, the tumor was spontaneously eliminated through violent abdominal contractions, which was followed by recovery of the animal’s state of health. Keywords: Homeopathy; Veterinary medicine; Tumors; Leiomyoma; Vaginal; Dogs.  Tratamento homeopático de leiomioma vaginal em cães: relato de caso Resumo As neoplasias vaginais mais comuns em cadelas velhas são o leiomioma e o fibroma. Embora a excisão cirúrgica é o tratamento indicado, não elimina complicações potenciais que podem levar ao óbito ou baixa qualidade de vida. O presente artigo relata o caso de uma cadela Doberman de 9 anos de idade, com leiomioma vaginal, apresentando colporragia copiosa e recidivante, tratada entre março e dezembro de 2005. A abordagem homeopática utilizada foi a desenvolvida na Unidade Homeopática do Hospital Veterinário da Universidade Federal Rural do Rio de Janeiro, Brasil. A evolução da doença foi acompanhada através de avaliação clínica, testes de laboratório e ultrassonografia. A hemorragia diminuiu e o estado geral melhorou. Depois de 7 meses de tratamento homeopático, o tumor foi espontaneamente eliminado através de violentas contrações abdominais, seguido de recuperação do estado de saúde do animal. Palavras-chave: Homeopatia, Medicina Veterinária; Tumores; Leiomioma; Vaginal; Cães.  Tratamento homeopático de leiomioma vaginal en canino: relato de caso Resumen Las neoplasias vaginales más comunes en caninos ancianos son el leiomioma y el fibroma. Aunque la excisión quirúrgica es el tratamiento de elección, no elimina complicaciones potenciales que pueden llevar al deceso o pobre calidad de vida. Este artículo relata el caso de un canino Doberman femenino de 9 años de edad, con leiomioma vaginal acompañado de colporragia abundante y recidivante, tratado entre marzo y diciembre de 2005. El abordaje homeopático utilizado fue el desarrollado en la Unidad Homeopática del Hospital Veterinario de la Universidad Federal Rural de Río de Janeiro, Brasil. La evolución de la enfermedad fue estimada mediante evaluación clínica, exámenes de laboratorio y ecografía. Las hemorragias disminuyeron, con mejoría del estado general. Después de 7 meses de tratamiento homeopático, el tumor fue espontáneamente eliminado mediante violentas contracciones abdominales, seguido de recuperación del estado de salud del animal. Palabras-clave: Homeopatía, Medicina veterinaria; Tumores; Leiomioma; vaginal; Perros.  Correspondence author: Luiz Figueira Pinto. luizfigueira@ufrrj.br How to cite this article: Ferreira MIC, Pinto LF. Homeopathic treatment of vaginal leiomyoma in a dog: case report. Int J High Dilution Res [online]. 2008 [cited YYYY Mmm DD]; 7(24):152-158. Available from: http://journal.giri-society.org/index.php/ijhdr/article/view/304/358. ÂÂÂ

Computed tomographic appearance of bladder and vaginal leiomyoma in dog: case report

Computed tomographic appearance of bladder and vaginal leiomyoma in dog: case report