Background: Vaginal leiomyoma is a rare solid tumor with variable clinical presentation. It is often difficult to diagnose, and its management is quite challenging. Case: The case of a 50- year-old multipara who presented with the chief complaints of menorrhagia, lower abdominal pain, and difficulty in defecation, is presented. On physical examination and ultrasonography, the tumor was diagnosed as a cervical fibroid that was 8×9 cm. Hysterectomy was planned, but as preoperative diagnosis of vaginal leiomyoma was made, the leiomyoma was removed by an abdominal route. Results: This patient's postoperative period was uneventful. Conclusions: Although it is a rare tumor, a vaginal leiomyoma may present with a variety of clinical features and may be mistaken preoperatively for a cervical fibroid. Excision and enucleation are the treatments of choice. Removal of the tumor through an abdominal route appears to be the optimum management plan if the base of the tumor is not approachable. (J GYNECOL SURG 30:187)
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