关键词: 外阴, 平滑肌瘤, 前庭大腺, 诊断, 治疗

Abstract:

Objective: To improve the diagnosis and treatment of vulvar leiomyoma. Methods: 8 cases of vulvar leiomyoma admitted to the Beijing Obstetrics and Gynecology Hospital of Capital Medical University from January 2009 to December 2023 were analyzed retrospectively, including their clinical characteristics, diagnosis, treatment and prognosis. Results: The average age of onset in 8 patients was 37.8 years (27-46 years). 6 patients presented with an enlarged or persistent vulvar mass, including one patient with vague pain, one patient with recurrence of vulvar leiomyoma after surgery, and the other two patients with no obvious symptoms. Only 4 patients underwent perineal imaging, none of them were suggested vulvar leiomyoma. All 8 patients were not diagnosed as vulvar leiomyoma preoperatively, and were treated by the excision of vulvar mass or the localized enlarged vulvar excision. 2 patients were diagnosed with vulvar leiomyoma by paraffin pathology, and the other 6 by immunohistochemistry. No recurrence was found in 6-158 months of postoperative follow-up. Conclusions: Vulvar leiomyoma is an extremely rare benign tumor, which is usually asymptomatic, being accompanied by a long history of painless vulvar swelling or vulvar mass. There is no specificity in imaging examination. Vulvar leiomyoma is often misdiagnosed as a Bartholin cyst or abscess before surgery. Surgery is the main treatment, which requires the complete excision of the leiomyoma and capsule. According to the situation, some normal tissues outside the edge of the tumor can be excised to reduce recurrence, and long-term follow-up is required after the operation.

Key words: Vulvar, Leiomyoma, Bartholin, Diagnosis, Therapy