Giant Fibroepithelial Polyps: Why Do They Grow Excessively?

Abstract

F ibroepithelial polyps or acrochordons are benign tumors of mesenchymal and ectodermal origin. They frequently occur in places where skin folds are present. Generally, their size does not exceed 5 millimeters. However, a case with a 42 centimeters long FEP has been reported in the literature. [1] There are different opinions about how FEPs reach these sizes and what triggers the growth. It is stated that the sensitivity of epithelium to hormones and hormonal changes may be the cause of the growth of FEPs, which are located in the genital tract and reached huge sizes. [2] It is also remarkable that FEPs located in this area are seen more frequently in women and in reproductive age. [3] It is not known exactly what triggered the growth of the FEPs that are located in other locations and reached huge sizes. However, a positive correlation between obesity, insulin resistance and FEP growth has been proposed. [4][5][6] Our case was unique concerning the FEP location. We did not find a similar case in terms of location and size in the literature. Our patient also had a ventriculoperitoneal shunt for six years due to idiopathic hydrocephalus. The shunt was 2 centimeters away from FEP. It may be thought that the foreign body reaction in this area may be an effect on FEP growth. In this report, we aimed to present our approach to a giant FEP and to examine the factors that cause FEP growth.

Multiple Vulvar Giant Fibroepithelial Polyps: A Rare Case Occurrence

“…Our patient came with complaints of large mass at the left side of her vulva that gradually increased from the size of a thumb until its current size. The vulvar fibroepithelial polyps generally do not exceed 5 mm, but there is literature reporting fibroepithelial polyps as long as 42 cm [ 2 , 4 , 10 ]. There are a number of cases of giant fibroepithelial polyp, but vulvar mass is rare, and even rarer is a mass reaching excessive dimensions.…”

“…There are different opinions about how fibroepithelial polyps reach these sizes and what triggers the growth. The growth of fibroepithelial polyps is caused by the sensitivity of the epithelium to hormones and hormonal changes located in the genital tract and can grow to enormous sizes [ 2 , 3 , 10 ]. It is also remarkable that fibroepithelial polyps located in this area are seen more frequently in women and in reproductive age [ 10 ].…”

“…Fibroepithelial polyps or acrochordons are benign skin tumors of mesenchymal and ectodermal origin. They occur in 25% of the population, and their frequency increases with age [ 1 , 2 ]. These tumors vary in their clinical appearance from small, flesh-colored or hyperpigmented, papillomatous growths resembling condylomata to large pedunculated tumors that often are hypopigmented.…”

“…They are usually found in skin folds, such as the neck, axilla, submandibular, or inguinal areas. However, it can be found in the genital tract, which has an epithelial structure sensitive to hormones [ 2 , 3 ]. The vulvar fibroepithelial polyps generally do not exceed 5 mm, but there is literature reporting fibroepithelial polyps as long as 42 cm [ 2 – 5 ].…”

Giant Fibroepithelial Polyps of the Vulva in a Woman with Uterine Myoma and Primary Infertility: A Case Report and Literature Review

“…Fibroepithelial polyps also vary in size. The literature contains a report of a 42-cm fibroepithelial polyp [ 2 ]. This disease is rare, because it has specific features and often overlaps with other diagnoses, because the stromal cells show a variety of immunophenotypes.…”