Leiomyoma of the Vulva: A quick Review
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Vulvar leiomyoma is a rare type of benign tumours of smooth muscle cells. So far, about 160 cases of vulval leiomyoma have been reported in English literature. Vulvar leiomyomas occur during the reproductive years and most patients present with a painless nodule or swelling in the labia. This benign tumour usually remains small for long period of time and grows slowly in the early period. As the swelling increases in size patients started to experience symptoms such as pain, itching and erythema. The patient in index was asymptomatic for 2 years and she did not seek any medical advice until she started to experience discomfort.

Differential diagnosis of vulval leiomyoma includes urBartholin cyst, Bartholin abscess, fibromas, lymphangiomas, soft-tissue sarcomas, and neurogenic tumos. Differentiation between benign and malignant vulval lesions can be challenging. This is due to rarity of the lesions and non-specific clinical presentation. On examination, vulval leiomyoma are usually non-tender, mobile with firm consistency.

Ultrasound is the most reliable imaging tool in establishing the diagnosis of uterine and extrauterine leiomyoma. Magnetic resonance imaging (MRI) is useful in differentiating benign and malignant lesions in difficult cases. A characteristic feature of malignant lesions on MRI is low signal intensity on T2-weighted images. Surgical excision of the tumour along with some of the surrounding tissues is the treatment of choice of vulval leiomyoma. Histologically, leiomyomas of the vulva are generally similar to their more commonly occurring counterparts in the uterine body. Follow up after surgery is recommended because of risk of recurrence.