Association of Psoriasis and Vulval Fibroepithelial Polyp

Abstract

Fibroepithelial stromal polyps of the vulvovaginal region display a wide range of morphologic appearances. This morphologic spectrum allows the correct diagnosis to be made in some cases but when histology reveals unusual features, the lesion may be misinterpreted as malignant. We present a case of a 35-year-old woman with psoriasis who developed a 15-cm polypoid lesion localized in the left labium. The labial lesion was resected and no recurrence was detected 12 months after the initial treatment. Histologically, the lesion exhibited the characteristics of a fibroepithelial stromal polyp with focal myxoid areas and underlying vulval psoriasis disease. The clinical, microscopic, and immunohistochemical findings of this case suggest a fibroepithelial polyp of the vulva. This vulval lesion represents a unique example of giant fibroepithelial stromal polyp developed in association with psoriasis.

A huge fibro epithelial polyp of the vulva with myxoid stroma in Tunisian nulliparous woman

“…Moreover, the potential role of hormonal influence is raised by the fact that FSP rarely occurs before puberty and multiple FSPs are often associated with pregnancy [8]. On the other hand, some diseases associated with FEP have been previously reported such as psoriasis [9] and congenital lymphoedema [10]. In summary, we report a new case of a giant FEP in Tunisian women complicated by abcesses.…”

A large fibroma polyp of labia majora

“…Other reports which had relatively large fibroepithelial stromal polyps include one case of a 10cm lesion in a young girl with a history of congenital lymphoedema, and one case of a 15cm lesion occurring in association with valval psoriasis. 9,10 Another case report documented a 15cm giant fibroepithelial stromal polyp and described the sonographic features as an adjunct to the diagnosis of fibroepithelial stromal polyp in large vulvovaginal lesions. 11 Other vulvovaginal lesions that can mimic fibroepithelial stromal polyps because of their well-circumscribed margins are angiomyofibroblastomas, superficial angiomyxomas and cellular angiofibromas.…”

Recurrent vulval fibroepithelial polyp with pregnancy: a rare presentation

“…3 Apart from the pregnancy it has also been reported in postmenopausal females following HRT 2 and females having dermatosis. 5 The clinical presentation may vary from small flesh colored, hypo or hyperpigmented sessile growth to large pedunculated polypoid formation or finger like projections, it is more frequent in the vagina followed of vulva and cervix. The size varies between 1-2cm to 15-20cm.…”

“…4 The pathogenesis has not been clarified yet; however evidences suggest that influx hormone plays a role, therefore small FEP associated with pregnancy regress spontaneously after delivery. 5 Immunohistochemically FEPs are often positive for desmin, vimentin, estrogen, and progesterone receptors and less frequent for actin. 2 The treatment of choice is surgical excision.…”