Fibroadenoma como causa de tumor en la vulva. Presentación de caso / Fibroadenoma as the cause of tumor in the vulva. A case report

Introducción: El fibroadenoma es una lesión bastante común en mama, pero su localización en la región vulvar es extremadamente rara, con alrededor de sesenta casos, descritos en la literatura. Se presenta como una masa unilateral, subcutánea y asintomática, de crecimiento insidioso. El tamaño de este tipo de lesión varía entre 1 y 12 cm en los casos reportados hasta la fecha. A pesar de ser infrecuentes, las tumoraciones a nivel vulvar continúan siendo importante motivo de consulta. La histogénesis de este tipo de lesiones ha sido tema de discusión en los últimos años, sobresalen dos teorías: la presencia de tejido mamario ectópico, y la degeneración tumoral de un grupo de glándulas similares a tejido mamario, descritas como componente habitual de la región. Objetivo: Aportar un diagnóstico diferencial polémico de tumores vulvares. Presentación del caso: Se presenta una paciente de 22 años con diagnóstico histopatológico de fibroadenoma de vulva. Se realiza exéresis de la lesión, la cual al examen macroscópico midió aproximadamente 15 cm en su eje longitudinal (la más grande reportada en la literatura). Conclusiones: A pesar de su baja frecuencia de presentación, el fibroadenoma de vulva es una entidad a tener en cuenta como diagnóstico diferencial de los tumores subcutáneos de localización vulvar(AU)

Introduction: Fibroadenoma is a fairly common lesion in the breast tissue, but its location in the vulvar region is extremely rare, with about 60 specific cases in the literature. It is presented as a unilateral, subcutaneous and asymptomatic mass, with insidious growth. The size of this type of lesion is between 1 and 12 cm in the cases reported to date. Despite being infrequent, vulvar tumors continue to be important reasons for medical consultation. The histogenesis of this type of lesions has been the subject of discussion in recent years; two theories stand out: the presence of ectopic breast tissue, and tumor degeneration of a group of glands similar to breast tissue described as a common component of the region. Objective: To providea polemic differencial diagnosis of vulvar tumors. Case presentation: We present a 22-year-old patient with histopathological diagnosis of vulvar fibroadenoma. Excision of the lesion was performed, which at the macroscopic examination measured approximately 15 cm in its longitudinal axis (the largest reported in the literature). Conclusions: Despite its low frequency of presentation, vulvar fibroadenoma needs to be considered as differencial diagnosis of vulvar tumors(AU)

Angiofibroma celular mesenquimatoso vulvar: reporte de un caso y revisión bibliográfica / Vulvar mesenchymal cell angiofibroma: A case report and literature review

Resumen: ANTECEDENTES: El angiofibroma celular (neoplasia mesenquitamosa) es un tumor poco frecuente conformado por células fusiformes y estructuras vasculares. Los angiofibromas celulares son neoplasias pequeñas, delimitadas, que pueden aparecer en mujeres de 40 a 50 años. CASO CLÍNICO: Paciente de 15 años, sin antecedentes patológicos de importancia para el padecimiento actual, que acudió al servicio médico debido a la aparición de una masa vulvar de crecimiento rápido, de 1 año de evolución. En la exploración física se observó una tumoración vulvar de 10 x 4 cm, en forma de herradura y en el contorno de la vulva se visualizó otra tumoración dependiente de la anterior, en el clítoris, de 7 x 5 cm, que simulaba un falo; ambas estaban adheridas a los planos profundos, sin causar dolor a la palpación, móviles, circunscritas, de consistencia blanda, con crecimiento de vello corporal en posición androgénica. Se llevó a cabo la resección del tumor; el procedimiento se inició con el acceso al labio mayor, sin afectar el meato uretral y el clítoris; se observó aumento de la vascularidad y la tumoración se disecó en su totalidad. El reporte histopatológico fue de angiofibroma celular. La evolución de la paciente fue favorable. CONCLUSIÓN: El angiofibroma celular de la vulva es una neoplasia mesenquimatosa con características clínicas, morfológicas e inmunohistoquímicas propias. El caso aquí expuesto es el primero reportado en una paciente adolescente.

Abstract: BACKGROUND: Cellular angiofibroma is a very rare tumor, it was described as a mesenchymal neoplasm, mainly made up of two components: spindle cells and vascular structures. Cellular angiofibromas are small-delimited malignancies and characteristically occur in women between 40 to 50 years of age. CLINICAL CASE: A 15-year-old female patient, with no pathological history of importance for the current condition, went to the medical unit due to the presence of a 1-year evolution vulvar mass, which was growing rapidly, 10 x 4 cm vulvar mass, horseshoe-shaped bearing the contour of the vulva, another tumor dependent on the previous in the clitoris area (7 x 5 cm), simulating a phallus, fixed to deep planes, not painful on palpation, mobile, circumscribed, of soft consistency, with growth of body hair in an androgenic position. In the surgical event, a tumor resection was performed, beginning an approach by the external part of the majors labia, respecting the urethral meatus and clitoris, an increase in vascularity was observed, dissecting the tumor in its entirety. The histopathological report was of cellular angiofibroma. The evolution of the patient was favorable. CONCLUSION: The cellular angiofibroma of the vulva is a mesenchymal neoplasm with the own clinical, morphological and immunohistochemical characteristics. The case presented is the first identity developed in an adolescent patient.

Giant Vulvar Fibroepithelial Polyp: A case series / Philippine Journal of Obstetrics and Gynecology

@#Fibroepithelial stromal polyp, more commonly known as acrochordon, skin tag, or soft fibroma is a type of mesenchymal tumor occurring among women of reproductive age. Fibroepithelial polyp, although the most common cutaneous tumor, is rare in the vulvovaginal region and there is currently no established protocol in approaching these kinds of lesions. Presented here is a series of cases of gradually enlarging labial masses among reproductive age women. These giant vulvar masses presented as solitary, flesh-colored, polypoid masses, initially non-tender but later becoming associated with local pain. Diagnosis is mainly through history, clinical examination aided by ultrasonography, and histopathologic examination, which would show a central fibrovascular core covered with squamous epithelium. Surgical excision serves as both diagnostic and therapeutic modality for these lesions. Vulvar fibroepithelial polyp do not seem to be as rare as literature says, they are relatively easy to diagnose and presents with benign clinical course.

Ureterocele prolapsado: un diagnostico para tener en cuenta ante una masa vulvar en una lactante. A proposito de un caso / Prolapsed ureterocele: a diagnosis to be considered for a vulvar mass in an infant. Case report

El ureterocele es una malformación del sistema urinario relativamente frecuente en niños; sin embargo, el prolapso del ureterocele a través de la uretra es una presentación, en extremo rara. La urorresonancia magnética es la prueba de elección para el diagnóstico definitivo. El tratamiento inicial de un ureterocele prolapsado consiste en la descompresión de la masa. Presentamos el caso clínico de una lactante de 7 meses con duplicación del sistema colector y ureterocele ectópico derecho, que apareció como una masa vulvar.

Ureterocele is a relatively common malformation of the urinary system in children; however, the ureterocele prolapse through the urethra is an extremely rare presentation. Urological nuclear magnetic resonance is the test of choice for definitive diagnosis. Initial treatment of a prolapsed ureterocele involves decompression of the mass. We report the case of a 7-month-old infant with duplication of the collecting system and right ectopic ureterocele appearing as a vulvar mass.

A Case of Angiomyofibroblastoma of the Vulva / 대한산부인과학회잡지

Angiomyofibroblastoma is a recently described mesenchymal tumor characterized by unique morphologic features, a propensity to arise in the vulva, and a non-aggressive beni-gn biologic behavior. It is typically well circumscribed and superficially located tumor and its cellularity is variable with hypercellular and hypocellular areas composed of bland-looking, pump stromal cells showing the immunophenotype of vimentin-/desmin - positive, and muscle specific actin(MSA)-/alpha-smooth muscle actin(ASMA) - negative. Spindle or plasm-acytoid cells are the characteristic cell types of most tumors. It is similar to an aggressive pelvic angiomyxoma in histology. Because of histologic similarity and differences in the clinical course and treatment, distinction from aggressive angiomyxoma was needed. It rep-resents new type in the expanding spectrum of tumors of which myofibroblasts constitute an integral component. We experienced a case of angiomyofibroblastoma of the vulva occuring in a 42 years old woman. The lesion was relatively well encapsulated mass(3 X 1.5 X 0.9 cm in dimension), showing intimate admixture of hypercellular and hypocellular area. The tumor contained prominent, somewhat ectatic vessels surrounded by smooth muscle cells, some of which blend or fan out from the muscular walls of the vessels. The margin was relatively free from tumor cells. At immunohistochemical stain, vimentin and desmin was diffuse and weak positive, smooth muscle actin was very a few and weak positive in tumor cells.