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Abstract
Background: Vaginal leiomyosarcomas are very rare clinical entity but clinical presentation varies considerably. Primary vaginal leiomyosarcoma accounts for 0.062% of malignant neoplasm of female genital tract. We are reporting a case of vaginal leiomyosarcoma mimicking as infective vaginal prolapse.
Case presentation: A 52 year old female presented with complaints of something coming out of vagina, intermittent bleeding and offensive vaginal discharge. Vaginal mass increased in size over the course of 3years. Local examination revealed a 7×7 cm irregular mass protruded through vulval outlet with multiple area of degeneration, focal hemorrhage and ulceration. On palpation, mass is moderately firm in consistency; originating from anterior vaginal wall. Vaginal myomectomy was done. On histopathology, leiomyosarcoma was diagnosed. Patient underwent total abdominal hysterectomy with bilateral salpingio-oophrectomy. Later on patient received radiotherapy. Cytology of peritoneal washings, biopsy of omentum, ovary and pelvic lymph node were found positive. Now, patient is well and free of disease.
Conclusion: Primary vaginal leiomyosarcoma is very rare occurrence. Complete Surgical excision with adequate margins is modality of treatment. The rare entity of disease has rendered us to paucity of information about the disease. Post operative radiotherapy has been used to reduce the local reoccurrence of the disease. The histo-pathological examination is only confirmatory method to reach definitive diagnosis. We strongly recommend frozen section biopsy to exclude malignancy for all vaginal leiomyomas.
