Leiomyoma of the Urethra in a Female: A Case Report.

Abstract

Introduction: Urethral leiomyoma is a rare benign mesenchymal tumor originating from urethral smooth muscles. The prognosis is good and there is no risk of malignant transformation. Local recurrence is also rare.We report a rare case of urethral leiomyoma in a young female. The aim is to emphasize that urethral leiomyoma can pose a diagnostic dilemma and most times mistaken as urethral prolapse, caruncle, papilloma, wart, urethrocele, urethral diverticulum and urethral malignancy. Case report: She is a 28 year old nulliparous female who presented with painful urethral mass, dysuria, dyspareunia, feeling of heaviness in her vaginal and bothersome storage lower urinary tract symptoms. Examination revealed a 4 x 4cm firm and tender mass at 3 O'Clock position with a short connecting stalk attached to the distal urethral wall. There was an area of necrosis inferiorly which did not bleed on contact. She had en-bloc excisional biopsy.Histological examination of the excised specimen revealed well circumscribed tumor with focal areas of urothelial lining. There are spindle-shaped smooth muscle fibers arranged in sheets with nuclei. There was no atypical, mitosis and pleomorphism suggestive of urethral leiomyoma. Conclusion: Urethral leiomyoma is a rare benigntumor of the urethral affecting females in their reproductive age. Surgical extirpation remains the main stay of treatment and recurrence is rare.