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BMJ Case Rep. 2010; 2010: bcr0520102985.
Published online Oct 8, 2010. doi:  10.1136/bcr.05.2010.2985
PMCID: PMC3028574
Rare disease
Giant fibroma of the vulva
Aniekan M Abasiattai,1 Aniefiok J Umoiyoho,1 Ivy N Umana,2 and Ntiense M Utuk1
1Department of Obstetrics/Gynaecology, University of Uyo Teaching Hospital, Uyo, Nigeria
2Department of Pathology, University of Uyo Teaching Hospital, Uyo, Nigeria
Correspondence to Aniekan M Abasiattai, animan74/at/yahoo.com
A 50-year-old grandmultiparous petty trader presented in the gynaecological unit of the University of Uyo Teaching Hospital with a painless groin swelling of 8 years’ duration, which had progressively increased in size. She had received several concoctions from a traditional healer who also made several incisions on her thighs and inguinal region. On examination, there were multiple scarification marks in the axilla, inguinal region and medial aspects of both thighs. There was a very huge, firm, non-tender mass involving the right vulva and measuring 40 by 35 cm (figure 1). The vaginal orifice was deviated to the left by the mass, the uterus was normal size and the adnexa were normal. She had an excision biopsy under general anaesthesia (figure 2) and the histology confirmed fibroma of the vulva (figure 3). She had an uneventful postoperative period and the wound healed well with good cosmetic results.
Figure 1
Figure 1
A huge vulva mass.
Figure 2
Figure 2
The vulva after the mass has been excised.
Figure 3
Figure 3
The histology confirming fibroma of the vulva.
Background
Vulval fibroma is very rare and there has not been any reported case of such a huge vulval fibroma in Nigeria.
Case presentation
The patient presented with a groin swelling of 8 years’ duration. Medical history was not significant. She was a divorcee and a petty trader who did not smoke or drink alcohol.
Treatment
Excision of the mass.
Outcome and follow-up
Good wound healing with no complications.
Giant vulval fibromas are very rare with few reported cases in the literature and none from Nigeria1 2. Vuval fibromas are found predominantly in young women although they have been reported to occur in infants, postmenopausal and pregnant women3. The tumour is often asymptomatic at its initial phase and, when they occur, symptoms are usually due to its increasing size and weight. Our patient presented at the hospital only after several forms of treatment with a local herbalist had failed. In addition, the mass had grown so large that her husband left her and she had stopped socialising. Complete excision of the tumour resulted in a cure, relieved her discomfort, improved her social status and would increase the acceptance of orthodox healthcare in her community.
Learning points
  • [triangle]
    Giant vuval tumours are very rare.
  • [triangle]
    They are often asymptomatic in the initial phase.
  • [triangle]
    Complete excision often results in a cure.
  • [triangle]
    There is a need to educate women in our rural communities on the need to present early in hospital when ill rather than use local herbalists and healers.
Footnotes
Competing interests None.
Patient consent Obtained.
References
1. Onwuhafua PI. Fibroma of the vulva: report of a case. Trop J Obstet Gynecol 2001;18:93–4.
2. Berlin M, Berlin S. Fibroma of the vulva: a case report. J Reprod Med 2007;52:533–4. [PubMed]
3. Wilkinson EJ, Xie D. Benign diseases of the vulva. In: Kurman RJ, ed. Blaustein's Pathology of the Female Genital Tract. Fifth edition New Delhi: Springer-Verlag; 2002:37–98.
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