# Thinking Twice about the Cervical Mass: A Case Report of Primary Vaginal Leiomyosarcoma and Review of the Literature

## TL;DR

This case report describes a rare vaginal cancer in a middle-aged woman and highlights the challenges in diagnosing and treating it.

## Contribution

The paper presents a unique case of primary vaginal leiomyosarcoma and offers surgical management insights for preserving fertility.

## Key findings

- The patient was diagnosed with vaginal LMS through surgical pathology and remains disease-free after 20 months.
- The report emphasizes the importance of localized surgical control for patients wishing to preserve fertility.
- Recommendations for treatment and surveillance are based on a review of the existing literature.

## Abstract

Primary vaginal leiomyosarcoma (LMS) is an unusual cause of aggressive gynecologic cancer which requires prompt surgical treatment for favorable outcomes. Definitive diagnosis and treatment render unique challenges to clinicians based on vague presentation and limited evidence for management. Here, we describe a case of vaginal LMS in a middle-aged woman with a history of cervical dysplasia found to have a proximal vaginal mass after presenting with vaginal discharge and cramping pain. The patient was diagnosed on pathologic surgical specimen and subsequently underwent definitive surgical treatment. She remains with no evidence of disease 20 months later. In our report, we emphasize the nuances of surgical management including localized source control in those desiring future fertility. Ultimately, we make recommendations for surgical treatment and surveillance based on the available published literature.