Leiomyoma Of The Vulva

Yıl 2013, Cilt: 10 Sayı: 38, 1594 - 1595, 01.04.2013

Murat Öz Bülent Köstü Emre Özgü

Öz

Vulval leiomyomas are rare tumors thought to arise from smooth muscle cells within erectile tissue or blood vessel walls or round ligaments remnants in the labium majus and they are clinically misdiagnosed as Bartholin cyst preoperatively. In our case, a 36-year-old woman presented with a 24 month history of painless swelling on her vulva. A surgical intervention was made with a preoperative diagnosis of Bartholin’s gland cyst. Pathological diagnosis was leiomyomas with hyalinised stroma. Major diagnostic problem with smooth muscle tumors of the vulva is the distinction between benign and malignant forms, since many vulval lesions have similar appearances making it difficult to distinguish benign from malignant lesions by gross inspection. The recommended treatment option is local excision of the mass with pathological examination.

Anahtar Kelimeler

Vulva, leiomyoma, vulval tumor, Bartholin’s gland leiomyoma

Vulvada Leiomyoma Olgusu

Öz

Vulval leiomyomlar nadir görülen, labium majusun erektil dokularındaki, kan damarlarının duvarlarındaki ya da round ligamentinin artıklarındaki düz kas dokusundan geliştiğine inanılan, preoperatif dönemde sıklıkla Bartholin kisti tanısı alan tümörlerdir. 36 yaşında 24 aydır vulvar bölgede ağrısız şişlik yakınma olan preoperatif Bartholin Kisti tanısı ile cerrahi girişim planlanan ve patolojik tanısı hyalinize stromaya sahip leimyom olarak değerlendirilen olgu sunulmaktadır. Vulval bölgedeki düz kas tümörlerinde en önemli tanısal problem benign ve malign formların ayrımında yaşanmaktadır, çünkü benign ve malign vulval mezenkimal tümörlerin büyük kısmının intraoperatif olarak ayırıcı tanısı yapılamayabilir. Önerilen tedavi seçeneği kitlenin lokal eksizyonu sonrası patolojik değerlendirilmesidir.

Anahtar Kelimeler

Vulva, leiomyoma, vulva tümörü, Bartholin bezi leiomyomu

Kaynakça

• Guardiola MT, Dobin SM, Dal Cin P, Donner LR. Pericentric inversion (12)(p12q13-14) as the sole chromosomal abnormality in a leiomyoma of the vulva. Cancer Genet Cytogenet 2010 May;199(1):21-3.
• Celik H, Bildircin FD, Kefeli M, Yavuz E, Kokcu A. Labial leiomyoma growing gradually in the vulva of an elderly woman. J Obstet Gynaecol 2012 Nov;32(8):816.
• Fasih N, Prasad Shanbhogue AK, Macdonald DB, Fraser-Hill MA, Papadatos D, Kielar AZ, et al. Leiomyomas beyond the uterus: unusual locations, rare manifestations. Radiographics 2008 Nov-Dec;28(7):1931-48.
• Kaufman RH, Gardner HL. Tumors of the vulva and vagina. Benign mesodermal tumors. Clin Obstet Gynecol 1965 Dec;8(4):953-81.
• Reyad MM, Gazvani MR, Khine MM. A rare case of primary leiomyoma of the vulva. J Obstet Gynaecol 2006 Jan;26(1):73-4.
• Nielsen GP, Rosenberg AE, Koerner FC, Young RH, Scully RE. Smooth-muscle tumors of the vulva. A clinicopathological study of 25 cases and review of the literature. Am J Surg Pathol 1996 Jul;20(7):779-93.
• Al Azzam M, Orrell JM, Vasey DP. Vulval leiomyoma with a myxoid hyaline stroma. J Obstet Gynaecol 2004 Nov;24(8):936.
• Tavassoli FA, Norris HJ. Smooth muscle tumors of the vulva. Obstet Gynecol 1979 Feb;53(2):213-7.