A rare case of benign vulvovaginal leiomyoma: Case report and literature review

Introduction: Smooth muscle tumors of the vulva are more difficult to diagnose and are frequently mistaken as Bartholin cysts prior to surgery. Case presentation: A 41-year-old female presented with a left vulvar mass that increased in size compared to the previous year. The patient had normal urination and a regular menstrual cycle. The presentation was not associated with dyspareunia, abnormal bleeding, and signs of infection (e.g., fever, vaginal discharge). The history of any sexually transmitted disease was inconclusive. There was also no family history of malignancy. Physical examination showed a solitary swelling mass, measuring 5 x 2 cm in the left labia majora at the site of the Bartholin gland. The mass was firm in consistency, partially movable, and non-tender with no inguinal lymphadenopathy. Histopathology after surgical removal revealed a benign vulvar leiomyoma. Discussion: Labia majora leiomyoma at the site of the Bartholin gland is rather uncommon. Some cases can develop into atypical leiomyoma or even leiomyosarcoma with local tissue infiltration. Conclusion: If the clinical picture is unusual, it is better to send the patient for ultrasound and MRI to exclude other causes followed by performing wide local surgical excision of the mass to allow proper histopathological and/or immunohistochemistry examination to differentiate between benign and malignant tumors.