When Word fails: a misdiagnosed vulvar leiomyoma mimicking a Bartholin's cyst

Vulvar leiomyomas are exceedingly rare benign tumours, with fewer than 300 cases reported to date. We report a case of a woman in her 20s with a long-standing vulvar swelling. Clinical suspicion was initially for a Bartholin's cyst, prompting treatment with oral antibiotics and referral for a Word catheter insertion. After an unsuccessful attempt at a Word catheter, the mass was instead enucleated. Histopathology confirmed a benign vulvar leiomyoma. Vulvar leiomyomas should be considered in the differential diagnosis of persistent vulvar masses and atypical Bartholin's cysts/abscesses. Surgical excision remains the definitive treatment and is usually curative, as well as allowing histological analysis for definitive diagnosis.