Fibroma mole gigante vulvar: relato de caso / Giant soft vulvar fibroma: case report

Fibroma mole, ou pólipo fibroepitelial, é uma lesão de proporções geralmente reduzidas, de cor hiperpigmentada ou igual à da pele, localizando-se frequentemente na face, pescoço, tronco e regiões intertriginosas. É um tumor classificado como benigno e pode acometer tanto homens quanto mulheres em idade reprodutiva e depois da quarta década de vida. Ocorre principalmente em obesos, diabéticos e durante a gestação. Com menor frequência, podem alcançar dimensões que excedem 5 cm. Seu crescimento pode ser lento ou rápido e comumente são assintomáticos, mas podem promover sangramentos por conta de ulcerações decorrentes de traumas repetidos. Apresentamos neste relato um fibroma mole, gigante, de localização vulvar, com 11 cm de comprimento, 11 cm de largura e 5 cm de espessura, pesando 500 g.

Giant soft vulvar fibroma is a fibroepithelial polyp lesion with generally reduced proportions, with a hyperpigmented color or similar to that of the skin, frequently located on the face, neck, trunk and intertriginous regions. It is a tumor classified as benign, can affect both men and women, of reproductive age and after the fourth decade, mainly obese, diabetic and during pregnancy. However, less frequently, they can reach dimensions that exceed 5 cm, may have a slow or accelerated evolution. They are commonly asymptomatic, but bleeding may be present due to ulcerations resulting from repeated trauma. In the current study, we describe a giant soft fibroma with a vulvar location measuring 11 cm in length, 11 cm in width, 5 cm in thickness and weighing 500 grams.

Quistes de inclusión epitelial, una extraña causa de aumento de volumen vulvar en niñas y adolescentes: un caso clínico / Cysts of epithelial inclusion, a strange cause of increased vulvar volume in girls and teens: a clinical case

Los tumores vulvares son un desafío diagnóstico en la práctica clínica por las múltiples etiologías subyacentes. CASO CLÍNICO: Adolescente de 13 años que presentó dos nódulos vulvares de un mes de evolución, asociados a leve dolor. Ecografía preoperatoria sospecha un quiste de inclusión epidérmica, el que se confirmó con biopsia excisional.

Vulvar tumors are a diagnostic challenge in clinical practice due to the multiple underlying etiologies. CLINICAL CASE: A 13-year-old adolescent who presented two vulvar nodules of one month of evolution, associated with mild pain. Preoperative ultrasound suspected an epidermal inclusion cyst, which was confirmed with excisional biopsy.

Early onset of action with a 17ß-estradiol, softgel, vaginal insert for treating vulvar and vaginal atrophy and moderate to severe dyspareunia.

OBJECTIVE: The softgel 17ß-estradiol (E2) vaginal inserts (4 and 10 µg; Imvexxy; TherapeuticsMD, Boca Raton, FL) are FDA approved for treating moderate to severe dyspareunia associated with postmenopausal vulvar and vaginal atrophy (VVA). The objective here was to determine responder rates at week 2 and whether week-2 findings predicted week-12 responders in the REJOICE trial. METHODS: Postmenopausal women received E2 vaginal inserts 4, 10, or 25 µg, or placebo for 12 weeks. Proportion of responders (having ≥2 of the following: vaginal superficial cells >5%, vaginal pH <5.0, or dyspareunia improvement of ≥1 category) were calculated. Odds ratios (ORs) for positive response at week 12 given a positive response at week 2 were determined in the efficacy evaluable (EE) population. RESULTS: The responder rate (in EE population [n = 695]) was 74% to 82% with E2 inserts versus 24% with placebo at week 2, and 72% to 80% versus 33% at week 12. Positive treatment responses were 9- to 14-fold higher with vaginal E2 than with placebo at week 2, and 5- to 8-fold higher at week 12. Response at week 2 predicted response at week 12 in the total population (OR 13.1; 95% CI, 8.8-19.7) and with active treatment only (OR 7.9; 95% CI, 4.7-13.2). CONCLUSIONS: A high percentage of postmenopausal women with moderate to severe dyspareunia responded with the E2 softgel vaginal insert at week 2, and a positive response at week 2 predicted a positive response at week 12.

Manifestações pleuropulmonares das doenças ginecológicas / Pleuropulmonary manifestations of gynecological diseases

Os autores apresentam revisäo da literatura acerca das principais doenças ginecológicas inter-relacionadas com alterações pleuropulmonares. Devido à diversidade das doenças primárias que podem determinar tais manifestações a distância e ao fato de este assunto näo ser usualmente abordado em livros-textos, consideram importante esta revisäo, com o objetivo de auxiliar a prática clínica

Vulval cancer following or co-existing with chronic granulomatous diseases of vulva: an analysis if its natural history, clinical manifestation and treatment

In this study a series of postgranulomatous vulval carcinoma is analysed. The epidemiological and clinical aspects are studied and guidelines for management of such tumours are given. The problem of clinical staging of this variety of tumour is discussed (AU)

Carcinoma of the vulva in Jamaican women.

Clinical and pathological analysis of vulvar carcinoma in 119 Jamaican women, treated at the University Hospital of the West Indies, over the past 18 years stresses that the tumor was more frequently seen in women under the age of 50 - contrary to the experience of authors from the Western metropolitan countries. The natural history of the tumor showed that in 51% of cases, vulvar carcinoma co-existed or followed previous chronic vulvar granulomatous diseases and showed a rapid tumor progression in these post-granulomatous cases. Features of other epidemiological and clinical important are discussed. Special reference has been made concerning the problem of applying FIGO staging of vulvar carcinoma.

Vulvar carcinoma in premenopausal Jamaican women.

Between the years 1958 and 1973, 119 patients with primary invasive cancer of the vulva were treated at the University Hospital of the West Indies, Kingston, Jamaica. Seventy-seven (64.7%) were premenopausal women. Because the pattern of the disease differed from that in late middle and older aged Jamaican women, the results of the disease are presented. The analysis stresses that vulvar carcinoma before menopause in our community is rare in the absence of various sexually transmitted granulomatous diseases of the vulva.

Vulvar carcinoma in premenopausal Jamaican women

Between the years 1958 and 1973, 119 patients with primary invasive cancer of the vulva were treated at the University Hospital of the West Indies, Jamaica. Seventy-seven (64.7 percent) were premenopausal women. Because the pattern of the disease differed from that in late middle and older aged Jamaican women, the results of the disease are presented. The analysis stresses that vulvar carcinoma before menopause in our community is rare in the absence of various sexually transmitted granulomatous diseases of the vulva (AU)