Leiomioma vulvar atípico

The evaluation criteria for the diagnosis of primary malignant smooth-muscle tumors of the vulva are size equal to or greater than 5 cm, infiltrating margins, more than 5 mitotic figures per 10 highpower fields, and moderate to severe cytologic atypia. Lesions with three or more of these features should be diagnosed as leiomyosarcoma while those with only one of these characteristics should be diagnosed as leiomyoma. Lesions with two of those features should be considered as atypical leiomyoma or low-grade leiomyosarcoma, with a risk of local recurrence rather than of metastatic disease. We report the case of an 87-year-old woman with an atypical leiomyoma of the vulva. Histological characterization of the tumor revealed a maximum diameter of 6.5 cm and 5-7 mitotic figures per 10 high-power fields. The patient underwent conservative treatment and follow-up.