Vulvar lymphoedematous pseudotumours mistaken for aggressive angiomyxoma: report of two cases.
BACKGROUND
We describe 2 cases of vulvar pseudotumour due to lymphatic obstruction with chronic lymphoedema of unknown cause that presented as a solitary mass that mimicked aggressive angiomyxoma.


METHODS
Both patients presented with a vulvar mass without medical history of trauma, surgery in the anogenital region or skin diseases. One patient was overweight (BMI = 26). Both surgically resected vulvar specimens were represented by a polypoid mass with a soft and a gelatinous cut surface.


RESULTS
Histologically, the presence of an abundant oedematous stroma with spindle-shaped cells and numerous thin-walled small-to-medium vessels may be confused with an aggressive angiomyxoma. The diagnostic key was represented by the massive oedema, rather than myxoid stroma, with the presence of dilated, tortuous lymphatic channels (some surrounded by clusters of lymphocytes) in the dermis.


CONCLUSIONS
The recognition of these lesions is important because they may be the cause of problems in differential diagnosis and therapeutic management. In fact, such lesions can be mistaken from both the clinical and histological perspective as a primitive tumour of the vulva-like aggressive angiomyxoma. However, these lesions are not true neoplasms and are likely due to lymphatic obstruction with lymphoedema. A simple surgical excision with vulvoplasty is curative.
D'Antonio
Antonio
A
AUO San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy. ada66 @ inwind.it
Caleo
Alessia
A
Boscaino
Amedeo
A
Mossetti
Gennaro
G
Iannantuoni
Nicola
N
D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D042601:Lymphatic Vessels / Q000473:pathology*; D008209:Lymphedema / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009232:Myxoma / Q000473:pathology*; D014844:Vulva / Q000473:pathology / Q000601:surgery; D014845:Vulvar Diseases / Q000473:pathology* / Q000601:surgery; D014846:Vulvar Neoplasms / Q000473:pathology*