Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, People's Republic of China.
Medicine (Baltimore). 2021 Feb 26;100(8):e24911. doi: 10.1097/MD.0000000000024911.
Vaginal leiomyoma is a rare type of leiomyoma that occurs on the wall of vagina. Treatment for vaginal leiomyoma is varied and is based on the location and size of the leiomyoma.
In this case, a 24-year-old newly married Chinese woman complained of dyspareunia. The physical examination revealed a solid mass on the anterior wall of vagina. It almost filled up the whole vagina cavity.
Transvaginal ultrasound showed a tumor on the anterior wall of vagina. Pelvic computed tomography (CT) and magnetic resonance imaging (MRI) also confirmed the tumor on vaginal wall. Fine needle aspiration biopsy confirmed fibrous and smooth muscle tissue in the tumor, and immunohistochemical examination found the estrogen receptor (ER) and progesterone receptor (PR) were positive.
6 courses of gonadotropin-releasing hormone (GnRH) analogue were given before the patient underwent complete surgical resection through vagina.
No postoperative complications occurred, and the patient was discharged from the hospital 3 days after surgery. Follow-up after 3 months revealed negative symptoms of genitourinary system. No sign of recurrence was found.
In this case, vaginal leiomyoma was diagnosed with help of imagological examinations like ultrasound, CT, and MRI, as well as pathological examination like fine needle aspiration biopsy. Preoperative GnRH analogue treatment can ensure smooth surgical procedure, and reduce blood loss during surgery.
阴道平滑肌瘤是一种罕见的发生在阴道壁的平滑肌瘤。阴道平滑肌瘤的治疗方法多种多样，取决于肌瘤的位置和大小。
本例患者为 24 岁新婚中国女性，诉性交困难。体格检查发现阴道前壁有一实性肿块，几乎填满整个阴道腔。
经阴道超声显示阴道前壁有一肿瘤。盆腔 CT 和 MRI 也证实了阴道壁肿瘤。细针抽吸活检证实肿瘤内含有纤维和平滑肌组织，免疫组化检查发现雌激素受体（ER）和孕激素受体（PR）阳性。
在患者经阴道完全切除肿瘤前，给予了 6 个疗程的促性腺激素释放激素（GnRH）类似物。
术后无并发症发生，患者术后 3 天出院。术后 3 个月随访时，泌尿生殖系统症状阴性，未发现复发迹象。
本例通过超声、CT 和 MRI 等影像学检查以及细针抽吸活检等病理检查，诊断为阴道平滑肌瘤。术前 GnRH 类似物治疗可确保手术顺利进行，并减少术中出血。
