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Fibroepithelial stromal polyps are site-specific mesenchymal lesions that are commonly found in the vulvovaginal region in premenopausal females. These polyps usually are less than 5 cm in diameter and are most commonly identified during routine gynecological examination. Although the stromal polyp is benign, its differential diagnosis includes som...
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Objectives
Aggressive angiomyxoma is known as a mesenchymal tumor of premenopausal women and it is extremely rare in men.
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Citations
... [1] They are uncommonly found in the vulva and few cases of giant FEPs of the vulva have been reported. [2] The first description of FEP was by Norris and Taylor [3] in 1966 while first case of vulva FEP was described by Ostör et al. [4] in 1988. They vary in sizes, but typically do not exceed 5 mm. ...
... 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. ...
... 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. ...
Fibro-epithelial polyps (FEPs), also referred to as acrochordons or skin tags, are benign tumours that generally occur in women of reproductive age. They are uncommonly found in the vulva and vary in clinical appearances from small papillomatous growths to large pedunculated tumours. Typically, they are less than 5 cm. The wide range of morphological appearances of these tumours, especially when they are large, can be misinterpreted as malignant. This case involved a 30-year old multipara, 14-month post-partum who presented with a huge, irregular, firm, pedunculated mass on the right labium majus. The mass had patchy areas of skin ulceration and measured 25 cm × 15 cm × 10 cm on a 4-cm × 2-cm long stalk. It started as a 3-cm long finger-like projection with globular distal end that progressively increased in size over 7-month period. There were no swellings in other body parts. She had excisional biopsy of the mass which weighed 588 grams with histological diagnosis of inflamed FEP and had no recurrence at follow-up. This case illustrates an uncommon presentation of the second largest FEP of the vulva reported, which could be misinterpreted as malignant. Clinical, and pathological expertise with complete surgical excision are paramount for effective management to exclude atypia or malignancy and prevent recurrence.
... Mientras que la mayoría de las pacientes presentan un crecimiento lento y constante, hay casos en los que lesiones pequeñas exhiben un crecimiento exponencial en un periodo corto (9) . Algunos artículos incluso describen aparición de novo y rápido crecimiento (10) , lo que se asemeja al primer caso descrito. ...
Los pólipos fibroepiteliales son tumores cutáneos benignos frecuentes en la poblacióngeneral. Sin embargo, la afectación del tracto genital es inhabitual. Su etiología no esclara, pero se han descrito asociaciones con trastornos metabólicos y fluctuacioneshormonales, lo cual explica su mayor prevalencia en mujeres. Debido a la variedad dediagnósticos diferenciales, es necesaria la evaluación histopatológica. Su manejo eshabitualmente conservador; sin embargo, pueden requerir intervención quirúrgicaen algunos casos. Exponemos cuatro casos de tumores fibroepiteliales vulvares dediferentes tamaños, uno de ellos clasificado como gigante, así como la aproximaciónde manejo. Con esta presentación, esperamos mejorar el conocimiento, la precisióndel diagnóstico y contribuir al tratamiento eficaz de las pacientes con esta patologíavulvar tan poco frecuente.
... FEPs in the lower female genital tract are benign growths, usually singular or less commonly multiple, characterized by the polypoid proliferation of stroma covered by squamous epithelium [3]. These lesions are hormone-sensitive and are commonly detected in women during their reproductive years, during pregnancy, or in premenopausal females taking hormone replacement therapy [4]. The incidence of fibroepithelial polyps, a benign mesenchymal tumor, is rare in prepubertal and postmenopausal individuals. ...
... Upon delivery, they may regress spontaneously [8]. Moreover, premenopausal females taking hormone replacement therapy may also present these polyps [4]. They can have polypoid or pedunculated characteristics and are usually solitary. ...
Although vulvar lesions are mostly malignant, polyps represent one of the most frequent benign tumors of the vulva, typically measuring less than 5 cm in size. Larger lesions are uncommon and are likely the result of mesenchymal cell growth in the hormonally responsive subepithelial stromal layer of the lower genital tract. Typically, vulvar polyps are asymptomatic in their initial stages, and patients often delay seeking medical attention due to sociocultural factors. In this report, we present a case of a giant vulvar polyp and examine the underlying etiology and symptoms of this condition, highlighting the life stages of women that are most frequently affected. Additionally, we emphasize the rare but potential occurrence of malignant forms.
... They may vary clinically from small flesh colored to hyperpigmented papillomatous growth resembling condylomata. Excep onally there are large pedunculated tumours as large as 15-22cm that 4,5 o en are hypopigmented. Symptoms may include bleeding, discharge and sensa on of a mass causing general discomfort apart from cosme c concerns. ...
The fibroepithelial polyps (FEPs) of vulva are uncommon tumours. They are benign in nature and mainly found in reproduc ve years. They are mostly solitary, pedunculated, and small in size. Histopathologically underneath the hyperplas c, surface epithelium stellate and mul nucleated stromal cells are present, the central core is fibrovascular. Presen ng symptoms usually include cosme c concerns, sensa on of a mass, bleeding, and discharge. For confirma on and to exclude malignancy biopsy is required. In literature, there is no men on of me taken for progression of polyp. We present a case of rapidly growing large fibroepithelial polyp of vulva.
... Fibro-epithelial stromal polyps (FSP) are non-epithelial benign growths of mesodermal origin. 1 They are typically seen in vagina, infrequently on vulva and rarely in extragenital sites. 2 Among the extra-genital sites, FSP of breast (nipple) have been previously reported in the literature. 3,4 Other sites include the external auditory canal, the tonsil, the ureter, oropharynx, the nasal vestibule and the eyelid. ...
... An 18.5, 15 and 13 cm giant fibroepithelial stromal polyp of vulva were described previously. 2,10 The maximum dimensions of breast (nipple) FSP described was 5.2 cm. 4 In our case the size of the polyp arising from the areola was 16cm in maximum dimension making this the largest FSP of breast ever reported. This giant size of the polyp in our case was due to the delayed presentation. ...
Fibro-epithelial stromal polyps (FSP) are benign mesodermal tumors. They are rarely seen in the breast. Most of them arise from the nipple. Other sites of origin are the external auditory canal, the tonsil, the ureter, oropharynx, the nasal vestibule, the eyelid etc. Though the occurrence and the rarity of FSP of nipple have been described previously, a FSP arising from the areola with intact nipple hasn’t been reported in the literature till date.
... Large (up to 18.5 cm) fibroepithelial polyps growing into a cauliflower-like (botryoid) pattern have been rarely documented in several anatomical sites [35]. They have been reported in the urinary bladder [10], anus [36] and the nipple [37]. ...
... Uncommon sites include the ureter, glans penis, vagina, vulva, perineum and skin. Due to occasional persence of atypical or bizzare-looking stromal cells, multinucleated cells, and myxoid stromal changes, these polyps have historically been termed pseudosarcoma botryoides or pseudosarcomatous polyps [31][32][33][34][35][38][39][40][41][42][43]. Grossly and histopathologically, botryoid fibroepithelial polyps may be indistinguishable from botryoid embryonal rhabdomyosarcoma. ...
... Grossly and histopathologically, botryoid fibroepithelial polyps may be indistinguishable from botryoid embryonal rhabdomyosarcoma. Hence, their differential diagnosis includes, amongst other lesions, embryonal rhabdomyosarcoma [44], as well as other entities, based on the anatomic location of the lesion [35,45]. ...
DICER1, a member of the ribonuclease III family, is involved in the biogenesis of microRNAs and, hence, it influences gene expression regulation. DICER1 germline (associated with the inherited DICER1 syndrome) or somatic mutations have been linked to tumorigenesis in histogenetically diverse benign and malignant neoplasms in different organs including pleuropulmonary blastoma, cystic nephroma, embryonal rhabdomyosarcoma, nasal chondromesenchymal hamartoma, poorly differentiated thyroid carcinoma, thyroblastoma, intracranial sarcoma and gonadal Sertoli-Leydig cell tumors in addition to others. Moreover, rare botryoid (giant) fibroepithelial polyps may harbor this mutation. Herein, we describe the first reported case of a DICER1-mutated botryoid fibroepithelial polyp occurring within the parotid duct of a 65-year-old female who has no other features or family history of the DICER1 syndrome. Based on its distinctive morphology, we tested this lesion specifically for DICER1 mutations and confirmed the presence of a pathogenic DICER1 variant with a low allele frequency, consistent with a somatic mutation.
... Soft fibroma (skin tags) is a slow-growing benign tumor of mesodermal origin most frequently arising in skin folds in locations like the neck, axilla, perineum, eyelids and chest wall; typically occurring in women of reproductive age. 1 Acrochordons are skin tags which are soft, papules with a stalk. A rare form of skin tag is fibroepithelial polyp, which, in contrast, is a bigger lesion with long, narrow stalk, and may appear pedunculated. ...
Fibroepithelial polyp (FEP) or acrochordon are skin tags frequently arising in skin folds in locations like the neck, axilla, perineum, eyelids and chest wall. Only 7 cases of FEP of the nipple have been reported in the literature so far. Here we report such a rare case diagnosed on FNAC and Biopsy.
... They are mostly small in size but can be giant, as in our case. 1 Pathology initially reported an FEP, but the differential diagnosis included angiomyxoma, which is one of the most common vulvar sarcomas. A second opinion and review of pathology were requested, and these confirmed the diagnosis of FEP with no malignant cells found. ...
... These lesions typically do not grow larger than 5-cm in diameter mostly. The lesions' size is 1×2cm [7] and is found incidentally during routine gynecologic exams [8] . Here, we present a case of a fibroepithelial stromal polyp arising from the low back of an 88year-old male, showing histological appearances of those described in the vulvovaginal region unusual manifestation of this disease. ...
... La presencia de características histológicas sorprendentemente atípicas dentro del pólipo puede dirigir en muchos casos a un diagnóstico erróneo, determinándolo como un sarcoma. [4][5][6] Los pólipos endometriales son una enfermedad ginecológica común, presentada como un sobrecrecimiento circunscrito, localizado de tejido endometrial (éste puede ser único o múltiple, sésil o pedunculado y puede llega a medir desde pocos milímetros a unos cuantos centímetros), compuesto de una cantidad variable de glándulas, estroma, con un eje central conjuntivo vascularizado y cubierto por epitelio en la cavidad uterina. Su estroma está compuesto de fibroblasto denso focalmente, así como de células fusiformes y grandes vasos sanguíneos con paredes gruesas. ...
ResuMen Los pólipos cervicovaginales son lesiones exofíticas fre-cuentes que abarcan desde protrusiones pequeñas y sésiles hasta grandes masas polipoideas y que además protruyen a través del orificio cervical. Éstos pueden ser clasificados como benignos, premalignos o malignos, y los tejidos componentes pueden ser de tipo epiteliales, mesenquima-les o mixtos. La mayoría de los pólipos cervicovaginales son asintomáticos y, por lo general, son descubiertos durante el examen pélvico o la evaluación patológica de una muestra de histerectomía. La mayoría son benignos y, menos de 1%, malignos. El objetivo principal de esta investigación fue determinar la incidencia de pólipos cervicovaginales en pacientes con vida sexual activa, así como las manifestaciones clínicas presentes en éstos. Se analizaron los resultados obtenidos de los interrogatorios a las pacientes que acudieron al Laboratorio de Biología Celular del programa de Detección Oportuna de Cáncer (DOC) durante el periodo de la primavera de 2001 a la primavera de 2018. De un total de 2,529 pacientes, 28 presentaron pólipo cervicovaginal y 2,501 no, por lo que la incidencia reportada fue de 1.10% en nuestras pacientes. AbstrAct Cervicovaginal polyps are frequent exophytic lesions that range from small and sessile protrusions to large polypoid masses that protrude through the cervical orifice. These can be classified as benign, premalignant or malignant and the component tissues can be epithelial, mesenchymal or mixed. Most cervicovaginal polyps are asymptomatic and discovered during the pelvic examination or the pathological evaluation of a hysterectomy sample. Most are benign and less than 1% malignant. The main objective of this investigation was to determine the incidence of cervicovaginal polyps in patients with active sexual life as well as the clinical manifestations present in these. The results obtained from the interrogations of the patients who attended the Cell Biology Laboratory of the Early Detection of Cancer program from 2001 to 2018 period were analyzed. Of a total of 2,529 patients, 28 presented cervicovaginal polyp and 2,501 no, which is why an incidence of 1.10% is reported in our patients. Palabras clave: Pólipos cervicovaginales, vida sexual activa, incidencia, manifestaciones clínicas. IntroduccIón L a palabra «pólipo» surge de la antigua palabra griega «polypus», que significa «muchos pies». Un pólipo cervical (CP) es una lesión benigna común del cérvix uterino que suele asociarse en mujeres adultas, pues su presencia en adolescentes es extremada-mente rara. La epidemiología exacta de los pólipos ginecológicos permanece incierta, no obstante, existe un número de teorías que han sido propuestas para explicar su etiología. De estas teorías, las modificaciones genéticas son actualmente las más estudiadas. La patogenia de los pólipos en el tracto reproductivo es altamente ambigua, aunque se ha registrado que un pequeño porcentaje se transforma en tumor; sumado a esto, se presentan muy pocos factores predisponentes para este fenómeno. El sangrado uterino es usualmente la queja más frecuente y no existen medidas preventivas para evitarlos, a pesar de que el tratamiento exitoso es posible siempre y cuando se use resección de histeroscopia, la cual es ahora conocida como «el estándar de oro» para su tratamiento, ya que ostenta una muy alta tasa de éxito y satisfacción en las pacientes. 1,2 Los pólipos ginecológicos son categorizados según la presencia o ausencia de tallo, tipo de tejido y localización. Si el tallo es estrecho y www.medigraphic.org.mx
