An Unusual Case of Vaginal Myoma Presenting with Postmenopausal Bleeding – ScienceOpen
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      An Unusual Case of Vaginal Myoma Presenting with Postmenopausal Bleeding

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          Abstract

          Vaginal leiomyomas are uncommon benign tumour with variable clinical presentation. These tumours arise most commonly from anterior vaginal wall. We report a case of 50-year old postmenopausal woman who presented with urinary retention, profuse vaginal bleeding and mass protruding into vagina. Local examination revealed a pedunculated mass attached to the posterior vaginal wall with vascular stalk one cm below the cervix. Mass was hanging outside vulva and vascular pedicle was profusely bleeding. The pedicle was ligated and tumour was excised. Subsequent histopathology revealed a vaginal myoma.

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          Most cited references6

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          Vaginal fibromyomata: two cases with preoperative assessment, resection, and reconstruction.

          Vaginal fibromyomata are rare benign neoplasms; approximately 300 have been reported in the world literature. The clinical presentation is variable and the consistency of the mass on pelvic examination may be misleading. A mass may occur anywhere along the vaginal tube and is usually localized, mobile, nontender, and circumscribed. Its consistency, however, may range from solid to cystic. These lesions may be asymptomatic or may cause pain or urinary tract symptoms. Transabdominal and intravaginal sonography along with needle biopsy are valuable in making the preoperative diagnosis of a benign smooth-muscle tumor. Vaginal enucleation is the treatment of choice. Operative management should include evaluation of urethrovesical support and possible reconstruction, eg, pubourethral ligament plication.
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            Vaginal masses: magnetic resonance imaging features with pathologic correlation.

            The detection of vaginal lesions has increased with the expanding use of cross-sectional imaging. Magnetic resonance imaging (MRI) - with its high-contrast resolution and multiplanar capabilities - is often useful for characterizing vaginal masses. Vaginal masses can be classified as congenital, inflammatory, cystic (benign), and neoplastic (benign or malignant) in etiology. Recognition of the typical MR imaging features of such lesions is important because it often determines the treatment approach and may obviate surgery. Finally, vaginal MR imaging can be used to evaluate post-treatment changes related to previous surgery and radiation therapy. In this article, we will review pertinent vaginal anatomy, vaginal and pelvic MRI technique, and the MRI features of a variety of vaginal lesions with pathological correlation.
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              Leiomyosarcoma of the vagina.

              Vaginal leiomyoma is uncommon and borderline leiomyoma of the vagina is an extreme rarity. Leiomyoma of the vagina may undergo malignant change to become borderline malignancy or leiomyosarcoma. A 38-year-old woman, complaining of foul vaginal discharge and dyspareunia with 2 months duration, underwent total excision of tumor. The removed tumor was diagnosed as borderline case of leiomyoma histologically. Unfortunately, she had tumor recurrence within 4 months. Thus, it was more likely that the primary diagnosis was incorrect and that the diagnosis leiomyosarcoma has been missed. She underwent total abdominal hysterectomy, bilateral salphingo-oophorectomy and total vaginectomy. The final diagnosis was leiomyosarcoma. Three months later tumor recurred again and re-excision followed by chemotherapy was performed. However, she died of her disease on her 5th month following three courses of chemotherapy.
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                Author and article information

                Journal
                J Family Reprod Health
                J Family Reprod Health
                JFRH
                Journal of Family & Reproductive Health
                Tehran University of Medical Sciences
                1735-8949
                1735-9392
                June 2013
                : 7
                : 2
                : 103-104
                Affiliations
                [1 ]Department of Obstetrics and Gynaecology, Gurugobind Singh Medical Hospital, Faridkot, Punjab, India
                [2 ]Department of Pathology, Gurugobind Singh Medical Hospital, Faridkot, Punjab, India
                [3 ]University college of nursing, Faridkot, Punjab, India
                Author notes
                Correspondence: Dr. Lajya Devi Goyal, Department of Obstetrics and Gynaecology, Gurugobind Singh Médical Hospital, Faridkot, 151203, Punjab, India. Email: lajja.goyal@ 123456rediffmail.com
                Article
                JFRH-7-103
                4064776
                b50cb3f1-c62a-48a2-8774-257b6e87ca09
                Copyright © Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                : February 2013
                : April 2013
                : April 2013
                Categories
                Case Report

                vaginal tumour,leiomyoma,post menopausal bleeding
                vaginal tumour, leiomyoma, post menopausal bleeding

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