http://dx.doi.org/10.5455/2320-1770.ijrcog20130219 Volume 2 · Issue 1 Page 99 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Sendhil CA et al. Int J Reprod Contracept Obstet Gynecol. 2013 Mar;2(1):99-100 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Case Report Paraurethral leiomyoma in a woman: a case report Sendhil Coumary A*, Seetesh Ghose, Rupal Samal INTRODUCTION Leiomyoma is a benign neoplasm commonly encountered in gynaecological practice. They are derived from smooth muscle cell rests. They are broadly classified as uterine and extra-uterine. A small percentage of Leiomyomas arise from the uterine ligaments, vulva, vagina and para- urethral region. Para-urethral leiomyomas are rare. Literature has reported only few cases till date. CASE REPORT A forty five year old multiparous lady approached the outpatient department, with complaints of profuse foul- smelling discharge and a mass per vaginum for ten days. Her menstrual cycles were regular with normal flow though with dysmenorrhoea. She is married for the past thirty years. She also gives history of dyspareunia over the last six months. Her general physical examination was unremarkable. An examination of the abdomen and the external genitalia was normal. Speculum examination revealed a fleshy, firm mass, measuring four x four centimeters, cephalad of the external urethral meatus. It was sessile and non-tender on palpation. On performing valsalva manoeuvre, the mass could be seen outside the introitus. Rest of the vagina and cervix were healthy. Bimanual and per rectal examination was unremarkable. A provisional diagnosis of paraurethral leiomyoma was made. Routine blood investigations done were found to be normal. Trans Vaginal Ultra Sonogram suggested a rounded heterogeneous pelvic mass. Enucleation of the leiomyoma under regional anesthesia was planned and carried out with ease (Figure 1). Figure 1: Intraoperative picture of the paraurethral leiomyoma. Bladder was catheterized prior to enucleation for early identification of urethral injury. Patient withstood the procedure well and was discharged on fourth post- operative day. On follow-up, the patient was totally symptom free. Histopathological examination showed a well-encapsulated lesion, consisting of interlacing fascicles and bundles of spindle shaped smooth muscle Department of Obstetrics & Gynecology, Mahatma Gandhi Medical College and Research Institute, Pilliarkuppam, Pondicherry-607402, India Received: 29 December 2012 Accepted: 6 January 2013 *Correspondence: Dr. Sendhil Coumary A E-mail: sendhilcoumary1975@yahoo.in ABSTRACT Paraurethral leiomyomas are rare, benign smooth muscle tumours of the urogenital tract. Most para-urethral tumours occur in the reproductive age group. Its etiology is uncertain and its presentation is variable. Here we present a 45 year old multiparous lady, who approached the out-patient department, with complaints of profuse foul-smelling discharge and a mass per vaginum for 10 days. Keywords: Paraurethral, Leiomyoma, Enucleation DOI: 10.5455/2320-1770.ijrcog20130219