PMC10246337_01
(a) Clinical photograph showing a pedunculated, large, mobile, soft-tissue mass over the vulva and (b) a computed tomography scan shows a nodular homogenously enhancing lesion on the vulva, (marked with an arrow).
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F1
A 51-years-old woman presented with a painless vulval mass since one year, gradually increasing in size [Figure 1a]. Magnetic resonance imaging of perineum was done and it was reported as a benign mesenchymal tumor [Figure 1b].
(a and b) Smears show a cohesive cluster of polygonal epithelial cells and overlying myoepithelial cells exhibiting focal tubular arrangements, with no pleomorphism or mitosis and necrosis along with fibromyxoid stroma. There is the presence of bare bipolar nuclei in the background. Cytomorphological features are of fibroadenoma vulva. Giemsa stain, x100 (a), x400 (b) (c and d) The excision biopsy section shows ductal epithelial cells in a pericanalicular pattern in the background of fibromyxoid stroma. The ducts were lined by bilayered epithelium, inner columnar epithelium, and outer myoepithelial cells. H and E stain, 100x (c); SMA, 100x (d).
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F2
Hence, a diagnosis of benign fibroepithelial lesion suggestive of fibroadenoma vulva was given and excision was advised [Figure 2a and b]. Microscopy showed a peri-canalicular pattern of ducts, lined by bi-layered inner columnar to cuboidal and outer myoepithelial cells with the absence of atypia, necrosis, or atypical mitosis [Figure 2c]. These ducts showed continuous cytoplasmic staining for SMA and nuclear p63 staining in the myoepithelial cells [Figure 2d].