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Thanasa E, Thanasa A, Kontogeorgis G, Gerokostas EE, Antoniou IR, Chasiotis A, Xydias EM, Ziogas AC, Kamaretsos E, Thanasas I. Fibroepithelial Polyp of the Vagina With Torsion: A Difficult Diagnosis Based on Clinical and Morphological Findings of the Vaginal Lesion. Cureus 2024; 16:e55157. [PMID: 38558656 PMCID: PMC10980332 DOI: 10.7759/cureus.55157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
Vaginal fibroepithelial polyps are rare benign tumors of the mucosa of the anterior vaginal wall. In extremely rare cases, they may originate from the posterior vaginal wall or be complicated by torsion. Our case concerns a 63-year-old patient who presented to the gynecology outpatient clinic of the General Hospital of Trikala with minor vaginal bleeding. On vaginal examination, a large pedunculated painless hemorrhagic polypoid mass was noticed, originating from the posterior vaginal wall. A torsion of the pedunculated vaginal tumor was suspected, leading to its surgical excision with clear resection margins. Due to extensive tissue necrosis, accurate histological identification of the vaginal neoplasm was not possible. Histological examination excluded vaginal malignancy. Based predominantly on the clinical and morphological features of the vaginal lesion, a diagnosis of vaginal fibroepithelial polyp with torsion was made, acknowledging its limitations. The patient was discharged from the clinic the same afternoon following the surgery. Three months later, no recurrence of the lesion in the vaginal wall was noted. Following the case presentation, this paper provides a brief literature review of this rare entity, focusing on the diagnostic and therapeutic approaches.
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Affiliation(s)
- Efthymia Thanasa
- Department of Histology, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Anna Thanasa
- Department of Anatomy, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | | | | | | | - Athanasios Chasiotis
- Department of Obstetrics and Gynecology, Limassol General Hospital, Limassol, CYP
| | - Emmanouil M Xydias
- Department of Obstetrics and Gynecology, EmbryoClinic In Vitro Fertilization (IVF) Unit, Thessaloniki, GRC
| | - Apostolos C Ziogas
- Department of Obstetrics and Gynecology, University of Thessaly, Larissa, GRC
| | - Evangelos Kamaretsos
- Department of Obstetrics and Gynecology, General Hospital of Trikala, Trikala, GRC
| | - Ioannis Thanasas
- Department of Obstetrics and Gynecology, General Hospital of Trikala, Trikala, GRC
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Tomita Y, Takabayashi E, Yuzawa S, Okizaki A. Superficial myofibroblastoma of the vagina with a stalk: case report of a rare vaginal tumor with notable radiological findings. Radiol Case Rep 2021; 16:3690-3694. [PMID: 34630802 PMCID: PMC8493509 DOI: 10.1016/j.radcr.2021.08.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 01/24/2023] Open
Abstract
Superficial myofibroblastoma is a rare benign mesenchymal tumor which predominantly occurs in the female lower genital tract. Here we present a case of a 42-year-old female patient with prolonged vaginal bleeding. Radiological imaging revealed a well circumscribed mass in the vagina with a stalk. The patient underwent surgery and the tumor was histologically diagnosed as superficial myofibroblastoma. Notably, this is the first report of the radiological imaging of a superficial myofibroblastoma harboring a stalk arising from the vaginal wall. We compared the radiological images with histological findings and discuss major differential diagnosis of vaginal tumors. Despite the challenging nature of preoperative diagnosis of mesenchymal vaginal tumors, radiological features may aid in differentiating them from other more aggressive entities or malignant tumors.
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Affiliation(s)
- Yui Tomita
- Department of Radiology, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan
- Corresponding author.
| | - Eriko Takabayashi
- Department of Radiology, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan
- Yoshida Hospital, 4jyo-Nishi4-1-2, Asahikawa, Hokkaido, 070-0054, Japan
| | - Sayaka Yuzawa
- Department of Diagnostic Pathology, Asahikawa Medical University Hospital, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan
| | - Atsutaka Okizaki
- Department of Radiology, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan
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Case Report and Review of the Literature of a Rare Entity of a Uterine Fibroid: A Genital Rhabdomyoma. Int J Gynecol Pathol 2021; 40:97-101. [PMID: 31851059 DOI: 10.1097/pgp.0000000000000660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Extracardiac rhabdomyomas are rare benign tumors. According to histopathologic and clinical characteristics, they are divided into 3 subgroups: adult, fetal, and genital rhabdomyomas. Various adult extracardiac rhabdomyomas have been reported in the head and neck region, whereas genital rhabdomyomas are uncommon. Here, we report on a uterine genital rhabdomyoma in a 32-yr-old woman with secondary sterility. After myomectomy, the histopathologic analysis showed a slow cycling tumor with striated muscle differentiation and without any evidence of malignancy. Immunohistochemical staining proved coexpression of actin, caldesmon, and desmin. To the best of our knowledge, this is the first case of a uterine-based genital rhabdomyoma.
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Thapa N, Basnyat S, Roka D. A Paraurethral Vaginal Mass in Rural Setting: A Case Report. JNMA J Nepal Med Assoc 2021; 59:601-603. [PMID: 34508403 PMCID: PMC8369561 DOI: 10.31729/jnma.6511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 06/14/2021] [Indexed: 11/02/2022] Open
Abstract
Paraurethral vaginal leiomyoma is the infrequent case to be described. Approximately 300 cases have been described so far. Imaging modalities aid in identifying the morphological, structural characteristics of the mass and its relationship to the surrounding structures. Thirty-six years old married women presented with a vulvar mass of (3x5) cm2. Her associated complaints were left shift of the urinary stream and dyspareunia. Ultrasonography and cystography revealed a mass with no relationship with bladder or uterine structure. Surgical excision was performed. The histopathological report confirmed the diagnosis of paraurethral vaginal leiomyoma. Surgical excision is the treatment of choice and diagnosis is confirmed by histopathological examination.
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Affiliation(s)
- Niresh Thapa
- Department of General Practice and Emergency Medicine, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Subi Basnyat
- Department of Obstetrics and Gynecology, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Dilsahi Roka
- Department of Obstetrics and Gynecology, Karnali Academy of Health Sciences, Jumla, Nepal
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Wethmar EI, D Mouton A, Dreyer G. Vaginal leiomyoma presenting as a lateral vaginal wall mass. SOUTHERN AFRICAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY 2017. [DOI: 10.1080/20742835.2017.1314630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
| | - Arnold D Mouton
- Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
| | - Greta Dreyer
- Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
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6
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Rare Epithelioid Leiomyoma of the Vagina Exhibiting a Pelvic Mass. Case Rep Obstet Gynecol 2017; 2017:2190135. [PMID: 28348906 PMCID: PMC5350389 DOI: 10.1155/2017/2190135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 02/20/2017] [Indexed: 11/17/2022] Open
Abstract
Epithelioid leiomyoma of the vagina is extremely rare. Smooth muscle tumors of the vagina usually present with a submucosal growth pattern or a pedunculated growth pattern from the anterior vaginal wall into the vaginal cavity. Here we report a case of a 43-year-old woman with a solid epithelioid leiomyoma and a palpable mass in the pouch of Douglas. Transvaginal biopsy and angiography showed the epithelioid leiomyoma feeding from the vaginal artery behind the posterior vagina. An abdominal wide excision of the tumor with a partial vaginectomy was performed. Our use of ultrasound-guided needle biopsy and angiography was useful for preoperative diagnosis of a vaginal epithelioid leiomyoma exhibiting a pelvic mass.
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Liaci AL, Boesmueller H, Huebner M, Brucker SY, Reisenauer C. Perivaginal benign masses: diagnosis and therapy in a series of 66 women. Arch Gynecol Obstet 2016; 295:367-374. [DOI: 10.1007/s00404-016-4234-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 11/03/2016] [Indexed: 10/20/2022]
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Endometrial stromal nodule of the vaginal wall with a review of vulvovaginal endometrial stromal neoplasms. Gynecol Oncol Rep 2015; 11:13-5. [PMID: 26076086 PMCID: PMC4434158 DOI: 10.1016/j.gore.2014.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 11/11/2014] [Indexed: 11/20/2022] Open
Abstract
It is reported the first endometrial stromal nodule (ESN) in the vagina. This is an excepcionall ESN because it was not associated with endometriosis It was successfully treated by local resection. Primary vulvovaginal endometrial stromal neoplasms are rare (only 5 reported)
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Patrelli TS, Franchi L, Gizzo S, Kiener A, Berretta R, Piantelli G, Caruana P, Battista Nardelli G, Bacchi Modena A. [Rhabdomyoma of the vagina. Case report and short literature review]. Ann Pathol 2012; 32:53-7. [PMID: 22325314 DOI: 10.1016/j.annpat.2011.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Revised: 06/24/2011] [Accepted: 08/17/2011] [Indexed: 11/16/2022]
Abstract
The differential diagnosis of vaginal polypoid masses should take rhabdomyoma into consideration even it is an extremely rare tumor. The present report describes a vaginal cystic mass located in the anterior wall of an asymptomatic, 38-year-old, Caucasian, nulliparous woman. Local excision and subsequent pathological examination were performed. The final diagnosis was vaginal rhabdomyoma. The literature is reviewed and differential diagnosis are discussed.
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Affiliation(s)
- Tito Silvio Patrelli
- Università degli Studi di Parma, Clinica Ginecologica ed Ostetrica, Parma, Italie.
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Thomas B, Magos A. Subtotal hysterectomy and myomectomy - vaginally. Best Pract Res Clin Obstet Gynaecol 2010; 25:133-52. [PMID: 21185235 DOI: 10.1016/j.bpobgyn.2010.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 10/22/2010] [Accepted: 11/02/2010] [Indexed: 11/28/2022]
Abstract
Vaginal subtotal (or supracervical) hysterectomy and vaginal myomectomy are elegant procedures rarely carried out by the average gynaecologist. Both techniques, however, are easily learned, and in view of the proven advantages of vaginal surgery over abdominal or laparoscopic approaches, they are worthy of a wider application. Subtotal hysterectomy may be preferred to excision of the entire uterus in certain circumstances, and may be carried out vaginally. Vaginal myomectomy allows for a more thorough myomectomy and stronger uterine repair than a laparoscopic procedure, as well as avoiding abdominal wounds. It may represent the optimal approach where fibroids are favourably sited. We first set out the case for subtotal hysterectomy and then describe the development of vaginal subtotal hysterectomy and vaginal myomectomy. We discuss the evidence supporting their use and indications, and then describe techniques for both vaginal procedures.
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Affiliation(s)
- Benjamin Thomas
- Minimally Invasive Therapy Unit and Endoscopy Training Centre, University Department of Obstetrics and Gynaecology, The Royal Free Hospital, Pond Street, Hampstead, London NW3 2QG, UK
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Vaginal Leiomyoma Presenting as Dysfunctional Uterine Bleeding. Taiwan J Obstet Gynecol 2010; 49:531-2. [DOI: 10.1016/s1028-4559(10)60113-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2009] [Indexed: 11/17/2022] Open
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12
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Yarcı A, Bayramov V, Şükür YE, Yüce T, Berker B. Vaginal Vault Leiomyoma: 25 Years After Total Abdominal Hysterectomy. J Minim Invasive Gynecol 2010; 17:116-7. [DOI: 10.1016/j.jmig.2009.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Revised: 10/03/2009] [Accepted: 10/11/2009] [Indexed: 10/20/2022]
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