IMR Press / EJGO / Volume 33 / Issue 4 / pii/1631087294983-236048628

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Case Report
An apparently benign vulvar mass: possibly a rare malignancy
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1 Department of Gynaecology, Obstetrics and Reproductive Sciences, Second University of Naples, Naples
2 Department of Medicine and Public Health, Second University of Naples, Naples
3 Department of Dermatology, Livorno Hospital, Livorno (Italy)
Eur. J. Gynaecol. Oncol. 2012, 33(4), 441–444;
Published: 10 August 2012
Abstract

Background: Vulvar dermatofibrosarcoma is a rare fibrous tumor of intermediate grade malignancy, with a tendency for local recurrence, and rarely metastasizes. Management should be multidisciplinary. This is a report of an apparently benign vulvar mass with delayed diagnosis of vulvar dermatofibrosarcoma. Case report: A 42-year-old woman was referred to our hospital because of a vulvar tumor lasting 16 years, although several gynecological procedures and a total laparoscopic hysterectomy had been performed two years before. During this long period the lesion did not change morphological features and remained asymptomatic. Only a benign vulvar mass was diagnosed. Then, the swelling became evident showing erythematous skin with an aspect of “peau d’orange”, leading the patient to consult a specialist. A firm vulvar swelling was observed in the anterior third of right labia majora continuing with about 3 cm of cord on top, quite movable above the underlying tissue but not on the overlying tissue. A wide excision was performed. The pathological examination showed positive margins. One month later an extensive deeper excision was performed. Histology confirmed a diagnosis of dermatofibrosarcoma. Immunohistochemistry was strongly positive for CD34. Conclusion: Vulvar lesions always require complete pathologic examination even in case of features of benign tumor to exclude a dermatofibrosarcoma. The role of the pathologist is essential to ensure negative microscopic margins and to avoid local recurrence.
Keywords
Vulvar neoplasms
Dermatofibrosarcoma
Vulvar mass
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