Giant Vulvar Molluscum Pendulum a Case Report and Review of the Literature

Abstract

Background: Molluscum pendulum (MP), also known as soft fibroma, is a benign fibrous cutaneous tumor arising from mesodermal tissue. While generally small and painless, MP can become unsightly and uncomfortable as it enlarges. Giant molluscum pendulum of the vulva, a rare variant of MP, presents unique clinical challenges. The aim of this study is to present and analyze a rare case of giant molluscum pendulum (MP) of the vulva, highlighting its clinical presentation, diagnostic challenges, and treatment outcomes.  Case Presentation: We report a 51-year-old female with a progressively enlarging perineal mass over 3 years. Physical examination revealed a pedunculated mass on the left labia majora, measuring 55 x 30cm, soft, painless, and mobile. Surgical excision under general anesthesia was performed, and the resected specimen weighed 850 grams with a diameter of 5 x 3 cm. Histopathology confirmed the diagnosis of giant vulvar molluscum pendulum. The surgical margins were clear, and the patient experienced a favorable recovery with no recurrence during a one- year follow-up.  Discussion: Molluscum pendulum is a benign pedunculated skin tumor commonly found in flexion areas but rarely on the vulva. Giant vulvar molluscum pendulum is characterized by significant growth and can be mistaken for other vulvar conditions, including Bartholin’s cysts and lipomas. Accurate diagnosis through histopathological examination is crucial. While the large size of the tumor is usually benign, potential malignancy must be considered. Surgical excision remains the most effective treatment, with further management reserved for malignant cases.  Conclusion: Giant molluscum pendulum of the vulva is a rare benign tumor that can grow substantially. Accurate diagnosis and prompt surgical intervention are essential for managing this condition effectively and preventing recurrence.