Prepubertal Vulvar Fibroma: Neoplasm or Physiological Condition?

• Published in: Journal of pediatric & adolescent gynecology Vol. 29; no. 5; pp. e67 - e70
• Main Authors: Goldrat, Oranite, MD, Lingier, Pierre, MD, Massez, Anne, MD, Noël, Jean-Christophe, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-10-2016
• Subjects: Child, Preschool; Diagnosis, Differential; Female; Fibroma - diagnosis; Fibroma - surgery; Hamartoma; Humans; Labial enlargement; Neoplasm; Neoplasm Recurrence, Local - surgery; Obstetrics and Gynecology; Pediatrics; Physiological labium asymmetry; Prepubertal vulvar mass; Vulvar Neoplasms - diagnosis; Vulvar Neoplasms - surgery; Neoplasm; Labial enlargement; Prepubertal vulvar mass; Physiological labium asymmetry; Hamartoma
• ISSN: 1083-3188; 1873-4332
• DOI: 10.1016/j.jpag.2016.02.003

Abstract Background Several authors have previously reconsidered vulvar fibroma, a rare prepubertal neoplasm, as a physiological labial asymmetry of early puberty, recommending a conservative approach for all cases, although some required further clarification. Case A fibrous mass found in the left labium majus of a 4-year-old girl was surgically removed. Imaging confirmed a relapse after 10 months and a second surgery was performed due to extremely rapid growth. No subsequent relapse occurred after 2 years of follow-up. Diagnosis confirmed prepubertal vulvar fibroma, with positive CD34 and lack of actin, desmin, S100, and estrogen receptors. Summary and Conclusion A diagnosis of prepubertal labial asymmetry should prompt careful consideration of several variables, such as age, and radiologic and histologic features, in order to differentiate between a physiological condition and a neoplasm.