2008, Number 6
Carral-Valdéz RA, Arellano-Sánchez E, Lira-Dale A, Aguilar-Baradas J, Pérez-Carillo O, Martín del Campo S
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ABSTRACTParaurethral leiomyoma is an uncommon benign neoplasm predominantly affecting women in the fourth or fifth decade of life. Its growth has been related to hormonal stimulation of the smooth muscle especially during pregnancy or with hormonal replacement therapy during menopause. Its clinical presentation is variable but it tends to be asymptomatic (50%). Of these cases, there is the sensation of the presence of a foreign body (78.6%) and dysuria (28.6%). Urethral and paraurethral leiomyomas should be differentiated clinically and with imaging studies such as ultrasound and magnetic resonance.
Clinical case: The disease initially presented one year ago with the sensation of a foreign body in the vaginal introitus of a 44-year-old female diabetic patient who had given birth more than once. The patient also presented with occasional dyspareunia. Medical examination revealed a 3x2 cm hardened, mobile, non-painful, euthermic mass. Transvaginal ultrasound showed a spherical, heterogeneous, well-defined, supraurethral, vascularized 3x2 cm image independent from the urethra. The mass was surgically removed and the anatomopathological diagnosis was paraurethral leiomyoma. There has been adequate 6-month disease progression with no recurrence. A review of the literature was carried out.