Large Vulvar Fibroepithelial Stromal Polyp Vs. Aggressive Angiomyxoma: The Importance of Histopathological and Immunohistochemical Diagnosis. A Case Report

Abstract

We present the case of a 34-year-old woman with a history of asthma, cesarean section, and bilateral tubal ligation, who reported progressive growth of a tumor on her right labium majus over nine years. Initially measuring 1 × 1 cm, it subsequently reached approximately 12 × 8 cm, causing discomfort during ambulation. Abdominopelvic computed tomography revealed a lobulated vulvar soft tissue lesion without evidence of deep infiltration. Complete surgical excision of the lesion was performed, revealing a tumor originating from the right labium majus and not adherent to deeper tissues. Histopathological examination revealed a stromal polyp. A 12.5 × 8 × 3 cm fibroepithelial lesion was found to be negative for malignancy. Immunohistochemistry showed positivity for desmin, CD34, and smooth muscle actin, confirming the diagnosis. The postoperative course was satisfactory, with no recurrence or complications. Stromal polyps fibroepithelial Vulvar tumors represent a rare entity whose main diagnostic challenge lies in differentiating them from other mesenchymal neoplasms Vulvar polyps , particularly aggressive angiomyxoma , are often compared to stromal polyps due to their clinical and histopathological similarities. Although they are usually lesions smaller than 5 cm, there are exceptional reports of massive growth. Definitive diagnosis requires surgical excision and histopathological analysis supplemented with immunohistochemistry . Positivity for desmin, CD34, and smooth muscle actin supports the benign mesenchymal origin of the lesion. Complete resection is the treatment of choice, as incomplete resections are associated with local recurrence. fibroepithelial Vulvar lesions are rare benign lesions that should be considered in the differential diagnosis of slow-growing vulvar masses. Histopathological and immunohistochemical evaluation is essential to distinguish them from aggressive neoplasms. Complete surgical excision allows for confirmation of the diagnosis, relief of symptoms, and a reduction in the risk of recurrence, thus improving patients' quality of life.