Asymmetric Hypertrophy of the Labium Majus in a 9-Year-Old Girl

Background: Childhood asymmetry labium majus enlargement (CALME) is an uncommon, benign condition that occurs in pre- and early pubertal girls and is characterized by a painless, fluctuating, non-tender labial swelling with normal overlying skin. Recognition of this benign condition is essential. Differentiation with several other diseases that mimic CALME and require different diagnostic and therapeutic approaches is mandatory. Two cases of CALME are described in this report. Differential diagnoses and therapeutic approaches are highlighted. Case presentation: The first case was an 11-year-old Caucasian girl referred to our hospital for the evaluation of right labium majus, which showed a palpable, painless, soft, non-tender, non-erythematous enlargement measuring approximately 2 cm with indistinct borders. Ultrasound showed a mass 23 × 18 × 12 mm in diameter. Surgical excision of the mass was performed and in the histopathological evaluation, the tissue specimens were composed of haphazardly arranged vascular channels, adipose tissue and nervous elements that were components of the vulvar soft tissue and were compatible with the diagnosis of CALME. Case 2 was a 6-year-old Caucasian girl who presented a post-traumatic painless mass of left labium majus swelling that progressively increased in volume. Ultrasound study evidenced an ill-defined heterogeneous echotexture mass 26 × 15 × 10 mm in diameter and magnetic resonance imaging confirmed these findings. Histopathological examination was performed after bioptic sampling evidencing normal constituents of vulvar soft tissue, including fibroblast, collagen, adipose tissue, blood vessels and nerves compatible with CALME. Conclusions: CALME is a particular clinical condition that occurs mainly in pre-pubertal girls and has a benign course but poses numerous problems in differential diagnosis that can be solved only with careful clinical observation and with a careful use of radiological imaging techniques. Our cases, in agreement with recent literature, suggest that radical excision is not recommended and that surgical biopsy should be taken into consideration only in cases of doubt.

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Pre-pubertal isolated plexiform neurofibroma of labium majus without clitoral involvement

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.1111/j.1600-0412.2012.01425.x ◽

2012 ◽

Vol 91 (8) ◽

pp. 1000-1000 ◽

Cited By ~ 2

Author(s):

Chanderdeep Sharma ◽

Shashank Shekhar ◽

Manupriya Sharma ◽

Swapnil Ulhas Rane ◽

Tanya Aggarwal

Keyword(s):

Plexiform Neurofibroma ◽

Labium Majus

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Extraskeletal Chondrosarcoma of Labium Majus

Case Reports in Pathology ◽

10.1155/2011/429562 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3 ◽

Cited By ~ 4

Author(s):

Arshad S. Khan ◽

Girish D. Bakhshi ◽

Aftab Shaikh ◽

Ashraf A. Khan ◽

Adil A. Khan ◽

...

Keyword(s):

Soft Tissue ◽

Adjuvant Therapy ◽

Indian Subcontinent ◽

Rare Tumor ◽

Extraskeletal Myxoid Chondrosarcoma ◽

Postoperative Course ◽

The Third ◽

Myxoid Chondrosarcoma ◽

Soft Tissue Swelling ◽

Labium Majus

Extraskeletal myxoid chondrosarcoma (ESMC) is a rare tumor seen more often in men. It is seen to arise from soft tissue of lower extremity or buttocks. We report a case of soft tissue swelling of left labium majus in a 66-year-old female. Patient underwent wide excision with uneventful postoperative course. Histopathology of specimen confirmed it to be ESMC. Patient refused adjuvant therapy. Followup of 1 year has shown her to be disease- and symptom- free. Only two cases arising from vulva have been reported in literature . This is the third case and first from Indian subcontinent. A brief review of clinical features, diagnosis, treatment, and outcome of patients with extraskeletal chondrosarcoma is presented.

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VIN 3: a clinicopathologic review

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200209000-00014 ◽

2002 ◽

Vol 12 (5) ◽

pp. 490-495 ◽

Cited By ~ 7

Author(s):

O. M. Mcnally ◽

N. J. Mulvany ◽

R. Pagano ◽

M. A. Quinn ◽

R. M. Rome

Keyword(s):

Gynecological Cancer ◽

Intraepithelial Neoplasia ◽

Complete Information ◽

Hpv Infection ◽

Vulvar Intraepithelial Neoplasia ◽

Invasive Squamous Cell Carcinoma ◽

History Of ◽

The Mean ◽

Labium Majus

A retrospective review of the management of vulvar intraepithelial neoplasia 3 (VIN 3) over a 16-year period from 1981 to 1997 was conducted. Complete information was available for analysis on 101 patients. The mean age was 53.9 years (range 14–102 years). The mean duration of follow-up was 36 months (range 2–184 months). Fifty-eight percent of patients presented with pruritus. The disease was multifocal in 51% and unifocal in 49% of cases and the left labium majus was the most frequently affected site (27%). Co-existent or previous genital disease was identified in 39% of patients and 8% had a history of invasive gynecological cancer. Histologic evidence of human papillomavirus (HPV) infection was found in 31% of patients. Wide local excision was the most frequently used treatment modality (78%). Thirty-eight percent of patients required at least one further treatment for recurrent disease. Smoking, multifocality, HPV effect, and positive surgical margins were not found to be significant predictors of recurrence. There were three (3%) cases of progression to invasive squamous cell carcinoma of the vulva, one at 6, 7, and 7 years after initial treatment.

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