A Rare Presentation of Vaginal Leiomyoma Originating Within a Patient without Uterine Fibroids: Morphology, Differential Diagnosis, and Clinical Significance

Leiomyomas can occur where smooth muscle is found, however they are most commonly seen within the myometrium of the uterus . Extrauterine leiomyomas are even more rare than uterine leiomyomas and present with greater diagnostic challenges. For example, vaginal leiomyomas are among the most rare reproductive neoplasms, as such only 300 cases have been reported in literature . Furthermore, they are thought to derive from Mullerian smooth muscle cells in the subepithelium of the vagina. Another potential theory is that this tumor came from a seeding of an existing uterine fibroid. Ultrasound imaging or MRI are helpful in the diagnosis of extrauterine leiomyomas and have the potential to show uterine fibroids of which the tumor may have originated from. Lastly, the tumor can have genetic origins and testing the tumor is useful in determining which genes may have played a role in its growth. This paper is a retrospective study following a 27-year-old patient with a vaginal leiomyoma and aims to discover its origin.