Intramural papilloma of the vagina: Evidence of Müllerian histogenesis

Abstract

A papillary tumor occurred in the posterior-superior vaginal wall of a 5-year-old girl who was free of recurrence one year following surgical excision. The light microscopic features included papillae lined by eosinophilic cells with uniform, bland nuclei, solid areas of identical cells, and scattered glandular lumina which contained mucopolysaccharides. Foci of eosinophilic hyaline globules were another distinctive feature. Electron microscopy of the tumor demonstrated features associated with müllerian neoplasms including projecting microvilli, whorls of perinuclear cytoplasmic microfilaments, conspicuous lysosomes, squamous metaplasia, complex cytoplasmic interdigitations, and pseudoinclusions of "cytoplasmic" collagen. Previously described "mesonephric papillomas" of the vagina and cervix are compared with the tumor of the authors' patient. The previously described tumors share some histologic and clinical features, although they were superficial rather than intramural proliferations. The authors conclude that the ultrastructure, location, and documented presence of müllerian structures in the vagina favor a müllerian origin for this vaginal tumor. A number of other vaginal tumors that occur in children and young women show different light microscopic features.

Benign papilloma of the cervix in childhood: immunohistochemical findings and review of the literature

“…Genital tract papillomas were believed to arise from remnants of the involuted mesonephric duct [7,12], but recent electron microscopic and immunohistological findings rather suggest a Mü llerian origin of these tumours [8,18]. In our study, positive staining of the epithelial cells for cytokeratin and L-CAM (also known as E-cadherin) is compatible with both, mesonephric and Mü llerian origin, since both antibodies indicate epithelial differentiation independent of tissue type [3,9].…”

“…Until now, only 26 children with genital tract papillomas have been reported in the literature [1,[5][6][7][8][11][12][13][14][15][16][17][18]. Most patients were small children, the youngest being newborn and the oldest 9 years of age.…”

Genital Sanguineous Discharge in Prepuberty: A Case of Mullerian Papilloma of Vagina in a 9 Year-Old Girl

“…Mullerian papilloma of genital tract, defined for the first time about 20 years ago by Ulbright et al 1 , can be a rare cause of genital bleeding in prepuberty 10 .…”

Benign Müllerian Papilloma of Childhood

“…Andrews et al [7] used these observations to support the view of a mesonephric origin for these tumors. Ulbright et al [8] interpreted their findings differently and suggested, instead, a müllerian histogenesis. Most recent contributors to this body of literature have supported this latter view, and have applied the term benign müllerian papilloma [9][10][11][12][13].…”