Perineal Leiomyoma

Abstract

Introduction: Leiomyomas are benign solid tumors derived from mesenchymal cells. At the gynecological level, they are located in the uterus, in 70% of cases. Paravaginal leiomyomas are a rare entity in adulthood (0.1%). Its diagnosis, according to histological and immunohistochemical criteria, is based on magnetic resonance imaging and ultrasound, among others. The first therapeutic option is its exeresis.
Objective: To report a clinical case referred to the emergency room due to Bartholinitis refractory to antibiotic treatment.
Case report: 29-year-old patient was referred to the emergency room due to Bartholinitis refractory to antibiotic treatment. A vaginal mass is observed extending towards the left paravaginal space. Biopsy of this lesion suggested the diagnosis of leiomyoma. Magnetic resonance imaging confirmed a 49-mm mass in the left ischiorectal space that appears to depend on the puborectalis muscle. Exeresis by enucleation was performed.
Conclusions: Excision and enucleation are the treatment of choice in all series. Vaginal excision can cause severe bleeding, if the base of the tumor cannot be reached entirely, or if it occurs in the upper third of the vagina.