DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20213495

Giant fibroepithelial polyp of vulva with fibroid uterus with primary lymphedema (Meige disease/lymphedema praecox): a rare case report

Apra Attri, Kamal Singh, Sita Thakur, Priyanka Sharma

Abstract


Fibroepithelial polyps or FSPs develop in the reproductive years of young to middle-aged women. They primarily affect the vagina, and their occurrence in the vulva is less common. Giant FSP are very rare. We present a case of a patient with giant FSP of the vulva with unilateral lymphedema. A forty year old patient presented with history of mild, dull, aching, continuous pain in lower abdomen. After her first delivery, she had developed pruritis over vulva followed by appearance of a growth. A non-tender, mobile warty growth was found on the examination of vulva, and it involved the mons pubis, clitoris and left labia minora and major. Dermatological consultation made a preliminary diagnosis of nevoid growth vulva. Operative findings from exploratory laparotomy confirmed that uterus had enlarged to 28 weeks size. The diagnosis of fibroepithelial polyp was confirmed by histopathological examination. A common pathogenetic background of lymphedematous FSPs is persistent lymph stasis, along with consequent injury of microcirculation and stromal hyperplasia. The role of hormonal factors in the development of these lesions in also supported by the Estrogen and progesterone receptor positivity. The association of FSPs with unilateral lymphedema, as in our patient, is very rare. This case provides some evidence that chronic lymph stasis can lead to microcirculation injury which further lead to stromal hyperplasia.


Keywords


Fibroepithelial stromal polyps, Lymphedema, Stromal hyperplasia

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References


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