Uterine leiomyomas, commonly known as fibroids, are the most prevalent pelvic tumors in females, affecting 20%-30% of women of reproductive age. These fibroids can lead to significant symptoms and morbidity. Vaginal fibroids are rare as primary vaginal tumors; approximately 300 cases have been documented in medical literature to date. Notably, there have been no reports of vaginal leiomyomas in Sub-Saharan Africa. A 28-year-old woman presented to our specialty hospital in Northern Tanzania at 30 weeks and 1 day of gestation with a vaginal mass that had been present since conception. She had a history of a vaginal mass that was excised in 2019 at a regional hospital. Magnetic resonance imaging revealed a soft tissue mass with a necrotic component, variable areas of restriction, and extra pelvic extension. The mass compressed the urinary bladder and vagina, as well as displacing the uterus upward and the rectum to the right side. The mass measured 21.7 × 13.5 × 9.0 cm. Due to premature rupture of membranes and fetal distress, she underwent an emergency cesarean section, and both mother and baby recovered well post-operatively. Three months later, she returned for excision of the vaginal mass, and the final histological report indicated a vaginal leiomyoma.
