Benign Phyllodes Tumor of the Vulva: A Case Report and Literature Review

Abstract

Phyllodes tumor is an uncommon breast lesion with characteristic histologic appearance when examined by hematoxylin and eosin staining: leaf-like fronds projecting into cystic spaces on low-power microscopy, and biphasic (epithelial and stromal) components on high-power microscopy. We report a rare primary case of this tumor arising within the vulva. A 34-year old African American female presented with a 3 cm slow-growing vulvar mass initially thought to be an inclusion cyst. The lesion was excised and histologic examination demonstrated this lesion to be a rare case of benign phyllodes tumor with morphologic features similar to those arising from breast tissue. Patient received no further treatment and did not exhibit any recurrence or metastasis. Nearly two years after excision, the patient died due to an unrelated medical cause. This rare tumor should be considered in the differential diagnosis for women presenting with a slow-growing vulvar mass.

Phyllodes tumour of the labia minora

“…Herein, we present a case of a benign appearing labial cyst which was pathologically determined to be consistent with a rare phyllodes tumour. Seventeen previously reported cases of vulvar phyllodes tumours have been reported in the literature2–12; however, our case represents the first reported tumour located in the labia minora. As these tumours are rarely found in the vulva, treatment and prognosis is less established13; we discuss the differential diagnosis, treatment and surveillance to be considered for these rare tumours.…”

“…Additionally, phyllodes tumours can be difficult to distinguish from other biphasic tumours, due to overlapping histological features. Fiboadenomas may rarely share the characteristic leaf-like architecture of the phyllodes tumour3; however, the stromal tissue in a fibroadenoma is typically paucicellular and lacks cellular condensation adjacent to the epithelium 14. Papillary hidradenomas originate from apocrine sweat glands and share a similar complex papillary growth pattern with phyllodes tumours though they exhibit a distinct double layer epithelial lining and lack a prominent stromal component.…”

“…Papillary hidradenomas originate from apocrine sweat glands and share a similar complex papillary growth pattern with phyllodes tumours though they exhibit a distinct double layer epithelial lining and lack a prominent stromal component. Chondroid syringomas arise from the eccrine sweat glands and are identified by areas of sebaceous and squamous differentiation 3. Given the stromal component of phyllodes tumours, they must also be discriminated from other soft tissue tumours that may present on the vulva, such as fibromatosis, neurofibromas, nodular fasciitis, angiomyxomas and angiomyofibroblastomas, although most of these tumours can be excluded if there is an epithelial component 2…”

“…There is no current classification or grading system for vulvar phyllodes tumours 3. Of the 17 reported cases, only 5 (29%) have been reported to be malignant,4 12 1 reported as borderline5 and the remainder reported as benign or not reported.…”

Fibroepithelial tumors of the anogenital mammary-like glands

“…Как и при патологии молочной железы, в аногенитальной области выделяют доброкачественные ЛО, пограничные (low grade) и злокачественные (high grade) [5]. В литературе описано всего 14 случаев доброкачественной ЛО аногенитальной области [46][47][48][49][50][51][52][53][54][55][56]. Подробная клинико-морфологическая характеристика ЛО АМПЖ представлена в таблице.…”