• Users Online: 768
  • Print this page
  • Email this page


 
  Table of Contents  
LETTER TO THE EDITOR
Year : 2016  |  Volume : 7  |  Issue : 6  |  Page : 548-549  

Broad based giant fibroepithelial polyp over an unusual location: A report


Department of Dermatology, Burdwan Medical College and Hospital, Burdwan, West Bengal, India

Date of Web Publication11-Nov-2016

Correspondence Address:
Surajit Gorai
Department of Dermatology, Burdwan Medical College and Hospital, Burdwan - 713 104, West Bengal
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.193922

Rights and Permissions

How to cite this article:
Gorai S, Saha A, Misra P, Nag S. Broad based giant fibroepithelial polyp over an unusual location: A report. Indian Dermatol Online J 2016;7:548-9

How to cite this URL:
Gorai S, Saha A, Misra P, Nag S. Broad based giant fibroepithelial polyp over an unusual location: A report. Indian Dermatol Online J [serial online] 2016 [cited 2019 Oct 22];7:548-9. Available from: http://www.idoj.in/text.asp?2016/7/6/548/193922

Sir,

Acrochordon or fibroepithelial polyp is commonly known as a skin tag. This is a benign, pedunculated and papillomatous growth of skin mainly composed of epidermal and stromal component. It is mainly seen in obese postmenopausal females. Usual size varies from 1 to 5 mm, rarely exceeds 2 cm involving intertriginous areas such as the neck, axilla, or groin.[1] Skin tag often appears or increases in number when a patient is gaining weight, having insulin resistance, or during pregnancy.[2]

Here we report an unusually large skin tag in a thin built, pubertal girl. A 17-year-old girl, presented to us with a large mass in her external genitalia for last 4 years. She noticed it when it was small; around 1 cm in size but it gradually enlarged over 4 years to attain this current large size. She felt discomfort during defecation, micturation, walking, and on wearing inner garments due to its large size. She was very apprehensive for its size and slow but constant growth. There was no pain, itching, redness, or other local symptoms. She was otherwise healthy without any systemic problem.

On cutaneous examination, a soft to firm, fleshy, corrugated, skin-colored large mass was hanging from left labia majora [Figure 1]a. It had an irregular, elongated, pedunculated base measuring 6 cm with broad, flat stalk that was attached with the large mass measuring 19 × 4 cm [Figure 1]b,[Figure 1]c,[Figure 1]d. The broad base almost entirely covered the whole left labium. This large papillomatous mass was folded in such a manner that it measured only 8 cm. There was no sign of inflammation or necrosis, the mass was nonpulsatile, nonreducible, with no impulse on coughing, no palpable thrill, or bruit with no regional lymphadenopathy. Pelvic and genitourinary examination was normal. Clinically it was diagnosed as giant skin tag of vulva. The lesion was excised with an elliptical incision over the labia majora alongside the base under local anesthesia and repaired meticulously [Figure 2].
Figure 1: (a) A large, folded papillomatous growth. (b and c) Measurement showing 19 cm length. (d) 6 cm elongated base over left labia

Click here to view
Figure 2: Immediate postoperative image showing the length of the broad base of the skin tag

Click here to view


Confirmatory histopathology showed mature stratified squamous epithelium, increased fibrocollagenous tissue in the stroma, thickened blood vessels, stellate fibroblast, and sparse perivascular chronic mononuclear inflammatory infiltrate without any evidence of malignancy [Figure 3]. The differential diagnosis of vulval acrochordon includes hernia, hydrocele of canal of Nuck, neurofibroma, lipoma, fibroma, bartholin's cyst, vulval varicosities, and hemangiomas.[3] Almost all these conditions including skin tag are diagnosed clinically; yet few simple investigations can differentiate between all these lesions. Ultrasonography or color Doppler study will diagnose the hernia, hydrocele, and vascular lesions. Histopathology is confirmatory in others. Stellate and multinucleate stromal cells present near the epithelial–stromal interface are the most characteristic feature of acrochordon.
Figure 3: Papillomatous growth of epidermis along with dermis and stromal tissue. Increased fibrocollagenous tissue in the stroma, thickened blood vessels and sparse perivascular chronic mononuclear inflammatory infiltrate (H and E, ×10)

Click here to view


This type of large lesion with a broad base is uncommon over vulva. In large lesions, surgical excision followed by histopathological examination is necessary to exclude malignancy.[4]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Canalizo-Almeida S, Mercadillo-Pérez P, Tirado-Sánchez A. Giant skin tags: Report of two cases. Dermatol Online J 2007;13:30.  Back to cited text no. 1
    
2.
Orosz Z, Lehoczky O, Szoke J, Pulay T. Recurrent giant fibroepithelial stromal polyp of the vulva associated with congenital lymphedema. Gynecol Oncol 2005;98:168-71.  Back to cited text no. 2
    
3.
Garg S, Baveja S. Giant acrochordon of labia majora: An uncommon manifestation of a common disease. J Cutan Aesthet Surg 2015;8:119-20.  Back to cited text no. 3
[PUBMED]  Medknow Journal  
4.
Ozkol HU, Bulut G, Gumus S, Calka O. Ulcerated giant labial acrochordon in a child. Indian Dermatol Online J 2015;6:60-1.  Back to cited text no. 4
[PUBMED]  Medknow Journal  


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References
    Article Figures

 Article Access Statistics
    Viewed2461    
    Printed3    
    Emailed0    
    PDF Downloaded110    
    Comments [Add]    

Recommend this journal