Early Diagnosis and appropriate management of vaginal leimyoma in rural areas

Abstract

Objective: To describe the challenges of early diagnosis and appropriate management of vaginal leiomyoma in rural areas.Case Report: A 26-year-old woman, P1A0, was referred from a rural hospital and presented a chief complaint of vaginal mass. The patient was admitted to thetertiary hospital with suspected malignant vaginal tumor and underwent a biopsy, which revealed leiomyoma on pathological examination. Despite conservative treatment, the mass continued to grow, unaffected by the menstrual cycle, causing discomfort. Following a second hospital admission, the patient underwent surgical management of extirpation and vaginal reconstruction. The microscopic finding of the tumor showed myositis cell proliferation with hyperplastic growth, monotonous nuclei, and variable cell shapes, supporting the diagnosis of vaginal leiomyoma. During postoperative monitoring, there was no vaginal bleeding. Thereafter, on the day following surgery, it was found that the right labium majorwas swollen. This was treated with anticoagulants, topical NSAIDs, and a sitz bath. The patient was discharged from the hospital in good condition and had an uneventful postoperative recovery.Conclusion: Although the incidence of vaginal leiomyomais uncommon, precise early diagnosis and appropriate management might improve outcomes, particularly in rural areas.