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BENIGN TUMOR EPIDEMIOL ETIOLOGY CLINICAL PATHOGENESIS MORPHOLOGY

VULVA OGY MANIFESTATION

Angiomyofibroblasto Usually middle aged uknown In rare cases, the tumor may Likely derived from Well circumscribed mass, 1 cm to 15 cm
ma females (fourth and fifth be observed to form a bag- subepithelial myxoid Homogenous pink gray cut surface with no
decades of life) like structure (pedunculated stromal zone of vagina necrosis or hemorrhage
tumor) and vulva
Rare single reports in Some women may Cellular angiofibroma has well-circumscribed
young and elderly experience a sense of margins, like
women pressure in the region, if the angiomyofibroblastoma. Microscopically, it is
tumor grows to large sizes composed of
Majority of the tumors are uniform, bland, spindle mesenchymal cells
less than 5 cm in size, while accompanied by numerous
some grow undetected to up thick-walled vessels and inconspicuous islands of
to 14 cm, due to a lack of mature fat
significant signs and
symptoms during the initial Microscopic (histologic) description
development stages
Pain during sexual Encapsulated tumor with hyper and hypocellular
intercourse areas and numerous vessels
Large tumors may result in Vessels may be hyalinized
the following: Hypercellular areas composed of plump stromal
Pain in the pelvic region cells that often congregate around vessels
Frequent urination due to Hypocellular areas are more spindled
compression/pressure of the Rarely mitotic figures and multinucleated cells
tumor
Lower back pain

Cellular Angiofibroma Women ages The exact cause of they most commonly CA pathogenesis still On gross examination, cellular angiofibroma
39 - 50 years Cellular Angiofibroma present as a relatively small remains unclear, since a typically is gray-white and has a firm, rubbery
Resemble labial occurrence is unknown. (mean 2.7 cm) subcutaneous subset of mesenchymal consistency
or Bartholin mass that is well cells of the distal female
gland cyst Cellular Angiofibroma is circumscribed and painless. genital tract normally Histologically, it is usually well circumscribed;
also shown to be expresses these however, focal infiltration into surrounding soft
First described closely related to two receptors and, at the tissue may be present. These tumors are
in 1997, benign benign tumors, namely same time, the characteristically cellular, composed of the
behavior in 2 of mammary-type neoplastic cells in other following: (1) short, intersecting fascicles of
2 cases myofibroblastoma and soft tissue disorders, bland, spindle-shaped cells with ovoid nuclei and
spindle cell lipoma, on arising from the vulva, scant palely eosinophilic cytoplasm; (2)
may also show
tumor cell genetic immunoreactivity for ER numerous small to medium sized, thick-walled,
study and/or PR and
often hyalinized blood vessels; and (3) admixed
wispy collagen bundles

BENIGN TUMOR EPIDEMIOLOGY ETIOLOGY CLINICAL MANIFESTATION PATHOGENESIS MORPHOLOGY

Condyloma It is estimated by the US Caused by human Single or multiple papular venereal disease caused Flat, dome shaped, keratotic, pedunculated or
acuminatum Centers for Disease papillomavirus eruptions may be observed. by HPV, usually type cauliflower shaped
Control and Prevention (HPV) Eruptions may appear 6. The better known Singly or in clusters
(CDC) that around 50% Majority due to low pearly, filiform, fungating, form is condyloma White, skin colored, pink, purple, red or brown
of all sexually-active risk HPV subtypes 6 cauliflower, or plaquelike. acuminatum, which is Most are asymptomatic but may exhibit
individuals may become or 11 but many characterized grossly by symptoms of pruritus, burning or pain
infected with the genital lesions have one or several soft May spontaneously regress
human papilloma virus multiple HPV Coital bleeding may occur. elevated masses of
Condyloma Acuminata subtypes Vaginal bleeding during variable Microscopic (histologic) description
of Vulva most commonly pregnancy may be due to size Acanthosis, dyskeratosis, parakeratosis,
occurs in sexually-active condyloma eruptions. hyperkeratosis and a prominent granular layer
individuals that include Cells of the basal layer of Superficial chronic inflammatory infiltrate in the
teenage girls and young Pruritus may be present. the epidermis are dermis
adult women; but, it can Discharge may be a invaded by human Perinuclear cytoplasmic “halos” with “raisinoid”
also occur in older complaint. papillomavirus (HPV). pyknotic nuclei or slightly enlarged nuclei
women These penetrate through (koilocytosis) in superficial epithelial cells
The infection occurs skin and cause mucosal Binucleated and multinucleated squamous cells
worldwide; there is no microabrasions. A latent Parabasal hyperplasia with accentuated
ethnic or racial viral phase begins with intracellular bridges
preference observed no signs or symptoms Enlarged parabasal cells with foamy or ground
and can last from a glass nuclear chromatin
month to several years. Regressing condylomas have increased stromal
Following latency, CD4+ T lymphoctyes
production of viral DNA, May contain areas of intraepithelial neoplasia
capsids, and particles especially in immunosuppressed patients
begins. Host cells
become infected and
develop the
morphologic atypical
koilocytosis of
condyloma acuminatum.

Consider sexual abuse as


a possible underlying
problem in pediatric
patients
Hidradenoma Papilliferum Hidradenoma The cause of Microscopically, it has a complex papillary
Papilliferum of development of It usually occurs as papules glandular pattern, with stratification and some
Vulva is an Hidradenoma on the skin, usually single, on degree of pleomorphism
uncommon Papilliferum of Vulva is the vulva and mitotic activity, sometimes brisk
condition that is unknown It is a slow-growing tumor
generally oily foods and and is usually painless and A myoepithelial Layer is always apparent
present in chocolate-based non-itchy Traditionally, this tumor has
young or products have an Some tumors can be been regarded as of sweat gland derivation.
middle-age influence on pigmented However, its close morphologic
women in the hidradenoma and immunohistochemical similarity with
age range of 20- papilliferum formation ulcerates through the skin intraductal
50 years and clinically may papilloma of breast and nipple adenoma
Individuals of all simulate carcinoma. suggests an origin from
racial and ethnic ectopic mammary tissue
background may
be affected,
though the
tumor is only
infrequently
seen in African
Americans. It is
more common
in Caucasians