[Leiomyosarcoma and leiomyoma of the vagina]

Sarcomas represent 2-3% of all gynecologic malignancies, only 10% occur outside the uterus. They are often not diagnosed before they reach an advanced stage. We report on a 56 years old women who had an exulcerated leiomyosarcoma of 8 cm in diameter in the posterior wall of the vagina. Initially she was treated by radiation, but the tumor showed a progressive growth. So she underwent a radical hysterectomy, radical colpectomy and vulvectomy, followed by six courses of adriamycinchemotherapy. 15 years later she is free of disease. Additionally we report on two women of 21- and 41-years of age with leiomyomas on the anterior wall of the vagina. These tumors were enucleated with an unconspicious postoperative follow up. In cases of leiomyosarcomas, which in most cases are located at the posterior wall of the vagina, radical surgery shows the best prognosis. Additionally a chemotherapy with adriamycin or ifosphamid can be used. Before surgery a biopsy is recommended to get a definitive diagnosis and to differentiate between benign and malignant lesions and to plan the optimal surgical strategy. In cases of leiomyomas they should be enucleated, because of the possibility of undergoing malignant change.