子宮平滑筋腫は35歳以上の女性の20から30％に存在する良性腫瘤であるが，まれに腟原発の平滑筋腫が生じることがある．43歳女性，G 2 P 2 （帝王切開 2 例），がん検診で腟前壁を主体とする5 cm大の腫瘤を指摘された症例を報告する．MRIでは境界明瞭な楕円形腫瘤で，T 2 強調像で比較的均一な高信号を呈し，軽度の拡散低下を示す．画像上は平滑筋腫としては非典型的であった．拡散低下を示す点で悪性を否定できずT 2 強調像で高信号を示す点で平滑筋腫としては非典型的であり，画像では診断に苦慮した．腟式腫瘍摘出術後の病理所見で腟平滑筋腫と診断された．今回平滑筋腫の非好発部位の腟原発であり，またMRI所見では平滑筋腫としては非典型的な信号を呈する症例を経験したので文献的考察を加え報告する．
1 ）Young SB, Rose PG, Reuter KL: Vaginal fibromyomata
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apparent diffusion coefficient value for distinguishing
benign from malignant myometrial tumours. Clin Radiol,
74: 571.e 9 －571.e18, 2019.
MRI 所見が非典型的な腟平滑筋腫
Abstract
A CASE OF VAGINAL LEIOMYOMA
WITH ATYPICAL MAGNETIC RESONANCE IMAGING FINDINGS
Motoki Nakamura, Mariko Hirayama, Yusuke Kobayashi,
Tadashi Yamaguchi, Kohei Mitsuhashi, Ryo Aoki, Shintaro Nawata,
Hiroyuki Kamide, Toshiaki Nishii, Zenjiro Sekikawa
Department of Diagnostic Radiology,
Citizen’s General Medical Center of Yokohama City University
Uterine leiomyomas are a common disease for women. However, leiomyomas originating from the vagina are
quite rare. A 43-year-old woman visited our hospital for detailed examination after a vaginal tumor was incidentally
detected on gynecologic cancer screening. Magnetic resonance imaging (MRI) showed a vaginal wall tumor showing
homogeneous mild high intensity on T2WI and intermediate intensity on T1WI, with mild high intensity on DWI,
with a slightly low ADC value. Since these signals are not typical for leiomyomas, and the location was also unusual,
it was difficult to diagnose the tumor as a leiomyoma. Surgical resection was performed, and pathological examination
showed that it was a leiomyoma of the vagina.
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