Multiple Vulvar Giant Fibroepithelial Polyps: A Rare Case Occurrence

Abstract

Fibroepithelial polyps or acrochordons are benign skin tumors of mesenchymal and ectodermal origin. They are seen in 25% of the population, and their frequency increases with age. They are often found in areas with skin folds, such as the neck, axilla, submandibular, or inguinal region. However, they can also be located in the genital tract. Hormone imbalances may facilitate the development of fibroepithelial polyp s (e.g., high levels of estrogen and progesterone during pregnancy). Larger lesions are likely to arise from the proliferation of mesenchymal cells within the hormonally sensitive subepithelial stromal layer of the lower. Generally, their size does not exceed 5 millimeters. We present a 28-year-old patient with multiple giant fibroepithelial polyps with size of 20 × 12 × 8 cm and 9 × 4 × 2 cm , located on both sides of her vulva. Herein, we presented our patient along with the review of current literature pertaining to the diagnosis and the treatment of fibroepithelial polyps (FEPs) and the factors leading to excessive growth.

Large vulvar fibroepithelial polyp and review of differentials

“…Essential pathology criteria for diagnosis include stellate and multinucleated stromal cells, typically found at the stromal–epithelial interface and around blood vessels: a polyp with variably cellular stroma, a central fibrovascular core and overlaying squamous epithelium. The lesions are benign, although they can recur locally, especially if they are not entirely removed or if hormonal stimulation is prolonged 8. The treatment of choice is complete local excision 9.…”

Giant fibro-epithelial polyp of the vulva: A case report

“…10 ] They occur in about 25% of population and frequency increases with age. [ 1 ] They occur commonly in areas with skin folds, such as the neck, axilla, submandibular, or inguinal regions; however, they can be found in the genital tract 9 ]; commonly in the vagina, uncommon in the vulva and rarely in the cervix,[ 2 11 ] and have been reported in rarer sites such as anterior chest wall,[ 1 ] colon,[ 12 ] and ureter. [ 13 ] This is a case of vulva FEP arising from the right labium majus.…”

“…However, giant FEPs of the vulva reaching excessive sizes are rare. [ 2 9 ] This case reported one of the largest giant FEP of the vulva with inflammatory changes in a woman of reproductive age.…”

Multiple Vulvar Polyps in Pregnancy: A Benign Disease With a Challenging Diagnosis

“…In fact, diagnosis may prove elusive, and differential diagnosis should be considered with malignant neoplasia such as vulvar rhabdomyosarcoma, but also with neurofibromas, melanocytic nevi, and condylomas. 21 During pregnancy, after confirming the diagnosis, deferring management is suggested due to possibility of spontaneous regression in the puerperium and to allow the normalization of vaginal vascularity, thus reducing the risk of hemorrhage with surgery. 16 Route of delivery, especially with numerous or large FEVP may need to be considered due to the risk of trauma.…”