Introduction/Background Different from Uterine leiomyomas which are common benign tumor in woman, Vaginal leiomyomas are very rare, having only 350 cases reported in the medical literature. However, leiomyomas are the most common mesenchymal tumors of the vagina in adult women, and can easily be misdiagnosed due to its low incidence and diverse, nonspecific clinical features.

Methodology A 43-year-old woman, para 2, visited our OPD department with chief complaint of about 4 cm sized prolapsing soft mass through vagina. Sonographic findings and physical examinations suggested vaginal cystic mass and surgery was recommended but the patient did not visited our center since she had so symptom other than intermittent prolapse. After 4 years later, the patient visited our center again with symptom of vaginal bleeding and discharge. About 6.0 cm by 5.0 cm semisolid vaginal mass near the urethra and bladder was found by sonography, and 8.3 by 5.6 cm sized mass lesion in the vagina was shown in abdomen CT finding, suggesting leiomyoma, most likely.

Results The patient received vaginal mass excision and anterior repair. About 8 cm protruding solid mass was found inside the anterior vaginal wall. Excision and anterior repair was done without any significant complications, and her hospital stay was 24 hours. Clinical and sonographic examination at a follow-up consultation, after 1 month, showed healed vaginal wall without any mass like lesion.

Conclusion Occurrence of leiomyoma in vagina is very rare, and its sarcomatous transformation is even rare but some case has been reported. Preoperative diagnosis is somewhat difficult and the gold standard of diagnosis is histopathological confirmation. Surgical removal with urethral protection should be done and histopathologic diagnosis should be made to rule out any possibility of malignancy.

Disclosure Nothing to disclose