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Abstract
Rare sites of myoma can present with unusual symptoms, which can cause clinical dilemmas in management. Leiomyomas are benign mesenchymal tumours which arise from smooth muscles. They are commonly found in the uterus. Leiomyoma in the vagina and urethra are a rare occurrence. The literature mostly reported cases of urethral leiomyoma arising from the proximal urethra. In our case, we report a distal urethral leiomyoma, which is an unusual location.
This young lady was a 32-year-old Filipino (Asian) lady who presented with mass per vagina, recurrent UTI, difficulty in micturition, discharge per vagina, the feeling of fullness in the vagina, difficulty and unpleasantness during sex for 2.5 years. She came with previous medical records & USG which disclosed many differential diagnoses of PID, cystocele, urethrocele, embryological remnant cyst, urethral diverticulitis and caruncle. She was treated for her complaints, nonetheless, her symptoms gradually became more disabling. After a thorough urogynecological investigation, which included an ultrasound, MRI with contrast and biopsy of the mass, the precise diagnosis of a distal urethral benign leiomyoma’ was made. She underwent a complete surgical excision under general anaesthesia, with excellent post-operative recovery, and was well relieved of all her complaints.
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References
- de Lima Junior MM, Sampaio CB, Ticianeli JG, et al. Leiomyoma – a rare benign tumor of the female urethra: a case report. J Med Case Rep 2014;8:366.
- Farman AG. Benign smooth muscle tumors. S Afr Med J 1974;48(28):1214.
- Fasih N, Prasad Shanbhogue AK, Macdonald DB, et al. Leiomyomas beyond the uterus: unusual locations, rare manifestations. Radiographics 2008;28(7):1931-48.
- Verma R, Mehra S, Garga UC, et al. Imaging diagnosis of urethral leiomyoma, usual tumour at an unusual location. J Clin Diagn Res 2014;8(11):RD04-6.
- Elsayes KM, Narra VR, Dillman JR, et al. Vaginal masses: magnetic resonance imaging features with pathologic correlation. Acta Radiol 2007;48(8):921-33.
- Buttner Ein Fall von Myom der Weibliehen Urethra. Z Geburshc Gynδk. 1894;28:135-36.
- Rivière P, Bodin R, Bernard G, et al. Leiomyoma of the female urethra. Prog Urol 2004;14:1196-8.
- Deka PM, Rajeev TP. Leiomyoma of the female urethra – a case report. Urol Int 2003;71:224–5.
- Perera ND, Senanayake L, Vithana VH, et al. An unusual presentation of female urethral leiomyoma. Ceylon Med J 2005;50(1):31-3.
- Dioszeghy F, Kiss A, Kondas J. Leiomyoma of the female urethra. Int Urol and Nephrol 1998;30(5):603-7.
- Pahwa M, Saifee Y, Pahwa AR, et al. Leiomyoma of the female urethra – a rare tumor: case report and review of the literature. Case Reports Urol 2012;2012:280816.
- Vilar G, Martin JP, Aguado M, et al. Leiomyoma of the female urethra: a case report and review of the literature. Actas Urol ESP 2010;34(4):396-7.
- Shield DE, Weiss RM. Leiomyoma of the female urethra. J Urol 1973;109(3):430-1.
- Chong KM, Chuang J, Tsai YL, et al. A rapidly growing paraurethral myoma with profuse bleeding from a mucosal vessel: report of a case. Gynecol Obstet Invest 2006;61(2):87-9.
- Goldman HB, McAchran SE, MacLennan GT. Leiomyoma of the urethra and bladder. J Urol 2007;177:1890.
- Jalde DD, Godhi SA, Uppin SM, et al. A case of urethral leiomyoma – a rare presentation. World J Sci Technol 2012;2:27-8.
- Ozel B, Ballard C. Urethral and paraurethral leiomyomas in the female patient. Int Urogynecol J Pelvic Floor Dysfunct 2006;17(1):93-5.
- Chaudhari VV, Patel MK, Douek M, et al. MR imaging and US of female urethral and periurethral disease. Radiographics 2010;30(7):1857-74.
- Siegelman ES, Outwater EK. Tissue characterization in the female pelvis by means of MR imaging. Radiology 1999;212(1):5-18.
- Parashar R, Philipraj J, Sasidharan K. Female urethral leiomyoma – a case report. Indian J Urol 2000;16(2):162-3.
References
de Lima Junior MM, Sampaio CB, Ticianeli JG, et al. Leiomyoma – a rare benign tumor of the female urethra: a case report. J Med Case Rep 2014;8:366.
Farman AG. Benign smooth muscle tumors. S Afr Med J 1974;48(28):1214.
Fasih N, Prasad Shanbhogue AK, Macdonald DB, et al. Leiomyomas beyond the uterus: unusual locations, rare manifestations. Radiographics 2008;28(7):1931-48.
Verma R, Mehra S, Garga UC, et al. Imaging diagnosis of urethral leiomyoma, usual tumour at an unusual location. J Clin Diagn Res 2014;8(11):RD04-6.
Elsayes KM, Narra VR, Dillman JR, et al. Vaginal masses: magnetic resonance imaging features with pathologic correlation. Acta Radiol 2007;48(8):921-33.
Buttner Ein Fall von Myom der Weibliehen Urethra. Z Geburshc Gynδk. 1894;28:135-36.
Rivière P, Bodin R, Bernard G, et al. Leiomyoma of the female urethra. Prog Urol 2004;14:1196-8.
Deka PM, Rajeev TP. Leiomyoma of the female urethra – a case report. Urol Int 2003;71:224–5.
Perera ND, Senanayake L, Vithana VH, et al. An unusual presentation of female urethral leiomyoma. Ceylon Med J 2005;50(1):31-3.
Dioszeghy F, Kiss A, Kondas J. Leiomyoma of the female urethra. Int Urol and Nephrol 1998;30(5):603-7.
Pahwa M, Saifee Y, Pahwa AR, et al. Leiomyoma of the female urethra – a rare tumor: case report and review of the literature. Case Reports Urol 2012;2012:280816.
Vilar G, Martin JP, Aguado M, et al. Leiomyoma of the female urethra: a case report and review of the literature. Actas Urol ESP 2010;34(4):396-7.
Shield DE, Weiss RM. Leiomyoma of the female urethra. J Urol 1973;109(3):430-1.
Chong KM, Chuang J, Tsai YL, et al. A rapidly growing paraurethral myoma with profuse bleeding from a mucosal vessel: report of a case. Gynecol Obstet Invest 2006;61(2):87-9.
Goldman HB, McAchran SE, MacLennan GT. Leiomyoma of the urethra and bladder. J Urol 2007;177:1890.
Jalde DD, Godhi SA, Uppin SM, et al. A case of urethral leiomyoma – a rare presentation. World J Sci Technol 2012;2:27-8.
Ozel B, Ballard C. Urethral and paraurethral leiomyomas in the female patient. Int Urogynecol J Pelvic Floor Dysfunct 2006;17(1):93-5.
Chaudhari VV, Patel MK, Douek M, et al. MR imaging and US of female urethral and periurethral disease. Radiographics 2010;30(7):1857-74.
Siegelman ES, Outwater EK. Tissue characterization in the female pelvis by means of MR imaging. Radiology 1999;212(1):5-18.
Parashar R, Philipraj J, Sasidharan K. Female urethral leiomyoma – a case report. Indian J Urol 2000;16(2):162-3.