Ulcerative fibroepithetial stromal polyp of the vulva with strong clinical suspicion for vulvar malignancy: A case report and mini‑review of the literature.

Abstract

Fibroepithelial stromal polyps of the vulva are rare clinical entities, typically appearing as isolated polypoid stromal lesions, covered by squamous epithelium. The presence of non-traumatic ulcerative lesions on the tumor surface, particularly when the tumor is relatively small, necessitates the differentiation from malignant lesions of the vulva. The present study describes the case of a 44-year-old patient who presented to an outpatient gynecological clinic, reporting as her sole symptom the presence of a mass in the vulval region, which had been increasing in size over the past 12 months. Upon examination and palpation of the external genitalia, a painless pedunculated tumor measuring ~5 cm, originating from the upper third of the right labium majus, covered with normal skin, but bearing ulcerative lesions, was found. An ulcerative fibroepithelial polyp of the vulva was suspected, and surgical treatment with wide excision of the lesion was decided upon. A histological examination of the surgical specimen confirmed the diagnosis. The immunohistochemical analysis of the tumor ruled out malignancy. Following an uneventful post-operative course, the patient was discharged from the clinic the following day. At 6 months post-operatively, no recurrence of the fibroepithelial polyp was found at the site of pedicle resection. The present study, also provides a brief literature review of this rare disease entity following the case presentation, highlighting the necessity of wide surgical excision of vulvar fibroepithelial polyps and their differentiation from vulvar malignancies.