Trichoepithelioma of the Vulva - Plastic Surgery Treatment - Case Report

Trichoepithelioma is very rare and benign skin lesion. It is arising from hair follicles. [1] This slowly growing cutaneous tumour most commonly arises on the face and scalp, neck and trunk, and usually presents clinically as single or multiple nodules. It is exceptionally rare on the vulva. Vulvar trichoepithelioma has complex histologic patterns. It originates in appendages that simulate malignancy. [2] There were only a few previous reports of cases, of such a tumour occuring on the vulva [1-3]. Case Report A 30-year-old women was referred with 5-year history of bothsided vulvar tumours multiple nodules, which had increased in size. On examination there were many small nodules localized under the skin of the labia majora, laying along its top margin (Figure 1). There were no other symptoms, or lymphadenopathy, but on the other hand, the patient was not well. She had decreased self-esteem and was ashamed of her appearance. She had one child birth in her past medical history and she planned to have another one, but in her opinion, it was impossible in such situation. She decided to remove tumours first. These psychological symptoms were the main reason of taking the decision for choosing the plastic surgical technique of excision the lession. It was excised under general anaesthesia. After beeing marked, the tumour was excised with RF tool. Left edges of the wound were smooth, without signs of nodules. The histology reported micronodular trichoepithelioma. Because of patient will, simultaneously with labia majora plastic surgery, the resection of left labia minora was performed (posteror wedge resection). On review the wounds were well healed. First control was presented 4 weeks after surgery. Patient was very well and satisfied of the plastic results. Proper shape of the vulva was preserved and no disturbances were reported by the patient (Figure 2).