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Angiomyolipoma of the vagina–an uncommon tumour. Case report

A 46-year-old Indian woman presented to the Department of Obstetrics and Gynaecology, University Hospital, Kuala Lumpur, in September 1986> with a complaint of progressive lower abdominal swelling of 3 months duration, but without abdominal pain. Her menses had been normal and there was no history of disturbance in micturition. On pelvic examination, the cervix was thought to be rather soft and ballooned out. The external 0s was not visible on speculum examination. The uterus was felt to be large, with the fundus almost reaching the level of the umbilicus. A pre-operative diagnosis of uterine myoma was made. Pre-operative intravenous pyelogram showed lateral displacement of the pelvic portion of the ureters with minimal hydro-ureter on the right side. There were no radiolucent areas in either kidney to suggest the presence of renal tumour. The patient also revealed no features suggestive of tuberous sclerosis. At laparotomy, the bladder was found to be displaced superiorly. In between the bladder and the normal-size uterus was a solitary large tumour measuring 20~12X10cm. This tumour appeared to arise from the anterior wall of the vagina (Fig. 1). It was densely adherent to the bladder and was dissected out with difficulty. A total hysterectomy, bilateral salpingectomy and complete excision of the mass was performed. Intra-operative diagnosis of a sarcoma was made.