Benign fibrous histiocytoma of vulva: rare case.

A 37-year-old woman was admitted on July 20, 2009, with complaints of gradually increasing vulval swelling for the past 3 years. The swelling was not painful, but was growing slowly. There was no history of anorexia, itching, loss of weight, or any other swelling over the body. She had normal menstrual cycles earlier, but recently she had 4 months of amenorrhea. She was married for the past 7 years and was nulligravida, and she did not take any treatment for infertility. There was past history of similar swelling 7 years ago for which an excision was done in March 2002. The histopathology report was suggestive of benign fibrous histiocytoma of the vulva. On examination, she was averagely built, poorly nourished, afebrile with stable vitals, and there was no inguinal lymphadenopathy. On abdominal examination, the abdomen was soft and there was no guarding, rigidity, or tenderness. No organomegaly was detected. Local examination showed a swelling of 12 9 4 9 3 cm over the right vulva extending from the mons pubis to the ischial tuberosity; there was inflammation around the swelling, with the overlying skin showing few patches of hyperpigmentation and Leukoplakia. The swelling was firm to soft with the overlying skin fixed to it. The swelling was not fixed to the underlying bone and was nontender. Per speculum examination revealed a healthy cervix and vagina. No abnormality was detected on per vaginal examination; however, it was painful. She was treated with injectable antibiotics and local dressing. On USG, the abdomen and pelvis were suggestive of bilateral simple ovarian cysts of 2.5 cm each with the rest of the pelvic findings normal. USG ? Doppler of the mass revealed an illdefined soft-tissue mass in the vulval region without calcification or necrosis with minimal vascularity. CT scan showed a homogenously enhancing soft-tissue density lesion arising from the right vulva. After the infection was cleared, the decision to excise the mass was taken. The vulval mass was excised completely and intraoperatively there was no hemorrhage; however, it was difficult to do the reconstruction of the vulva. The mass was sent for histopathologic examination. The post-op period was uneventful. The histopathologic report came as recurrence of benign fibrous histiocytoma of the vulva. Kamble S. N. (&), Associate Professor Sambarey P. W., Professor and HOD Department of Obgy, B.J. Medical College & Sassoon General Hospital, Pune PIN 411001, India e-mail: [email protected] The Journal of Obstetrics and Gynecology of India (December 2012) 62(S1):S85–S86 DOI 10.1007/s13224-013-0370-x