Fibroepithelial Stromal Polyp Research Articles

Fibroepithelial Stromal Polyp of the Vulvovaginal Region as Part of the RB1 Family of Tumors: Friend or Foe?

Fibroepithelial stromal polyps (FSPs) are benign mesenchymal lesions occurring in the vulvovaginal region. Following the identification of loss of Retinoblastoma 1 (RB1) on immunohistochemical staining in routine practice, we stained a series of FSPs and performed additional fluorescence in situ hybridization (FISH) and copy number variation (CNV) sequencing to detect losses/deletions in the Retinoblastoma transcriptional corepressor 1 (RB1) gene. Fifteen FSP cases were stained for RB1, and subsequently, 9 cases were examined by FISH to detect a loss of RB1 (13q). Next, CNV sequencing was performed to assess genomic alterations. The mean age of the patients was 50 years. Loss of RB1 expression on immunohistochemistry was seen in 13 cases, and heterogeneous RB1 staining in the remaining 2 cases. FISH showed deletion of RB1 in all of the cases. CNV sequencing failed in almost all cases due to a low tumor content. Based on our findings, we hypothesize that FSPs are part of a spectrum of genetically related lesions, namely the 13q/RB1 family of tumors (which includes pleomorphic fibromas and spindle cell/pleomorphic lipomas). Due to the clinical, morphologic, and molecular overlap, we suggest that FSPs are pleomorphic fibromas occurring in the specialized stroma of the genital region.

Pitfalls in Pathology-Fibroepithelial Stromal Polyp of the Bladder

Abstract Introduction/Objective The fibroepithelial stromal polyp is a benign polypoid proliferation of the stroma with overlying, usually squamous epithelium. It was originally reported in 1966 and is a generally recognized lesion of the female genital tract. Because the lesion contains atypical stromal cells, it can be mistaken for a sarcoma, particularly if it shows hypercellularity, pleomorphism, and atypical mitoses. It is often found in the female lower genital tract, urethra, and rarely extragenital sites, such as the breast. Other unusual locations such as the anus and nasal cavity have also been reported. The lesion is hormonally related and affects mostly reproductive-age women. Rare cases were reported in the male urinary tract and genital area. Because it is not well known in the bladder, overinterpretation as a sarcoma is possible. Methods/Case Report We report a ~60-year-old patient with a history of lower urinary tract symptoms due to prostatic hypertrophy on maximal medical therapy. He had been experiencing hematuria. On office cystoscopy, he was found to have a 3 cm prostate mildly obstructing the urethra, and 2 small velvety, erythematous patches on the posterior bladder wall. At cystoscopy, he was seen to have a small posterior bladder lesion, which was resected without difficulty. The pathology laboratory received two fragments of pink/tan soft tissue measuring 0.1 and 0.2 cm in the greatest dimension. On histology, the overlying urothelium was benign. The stroma was collagenous and hypocellular, containing scattered atypical and multinucleated cells, similar to the fibroepithelial stromal polyp well recognized in the female lower genital tract. Results (if a Case Study enter NA) N/A. Conclusion Benign fibroepithelial stromal polyp is an uncommon lesion usually seen in the lower genital tract of reproductive aged women. The presence in the bladder of a male is exceptionally rare. Recognition of the lesion will prevent overdiagnosis as a malignancy.

A rare giant fibroepithelial stromal polyp arising from the areola of breast-a case report

Fibro-epithelial stromal polyps (FSP) are benign mesodermal tumors. They are rarely seen in the breast. Most of them arise from the nipple. Other sites of origin are the external auditory canal, the tonsil, the ureter, oropharynx, the nasal vestibule, the eyelid etc. Though the occurrence and the rarity of FSP of nipple have been described previously, a FSP arising from the areola with intact nipple hasn’t been reported in the literature till date.

Fibroepithelial stromal polyp of vagina in pregnancy - A mimicker

A rare mesenchymal neoplasm of the lower female genital tract, fibroepithelial stromal tumor, may be confused with other more aggressive lesions. The appearance in pregnancy may further complicate a normal vaginal delivery and lead to confusion with a more unfavorable diagnosis. Even on histological examination, it is pertinent to rule put other stromal tumors of the region. To avoid overdiagnosis, the pathologist must be aware of the specific histomorphology. We report a case of fibroepithelial stromal polyp in a 32-year-old pregnant woman as an incidental finding during a routine antenatal check-up.

Nipple Papilloma with Dysplasia: A Case Report

Nipple papilloma is an uncommon benign breast tumour. Polypoid lesions arising from the surface of the nipple include nipple papilloma, fibroepithelial stromal polyp of the nipple. These must be differentiated from malignant lesions involving the nipple, like Paget’s disease of the nipple, and malignant breast lesion with nipple involvement. Detailed clinical examination, and to a great extent, imaging helps to differentiate these lesions. Hereby, authors report a case of 46-year-old female presented with abnormal growth arising from the right nipple. On full field digital mammography, bilateral breasts revealed scattered fibroglandular breast parenchyma {American College of Radiology (ACR) type B). An irregular hyperdense mass with lobulated margins is seen superior to right nipple which measured approximately 16×14 mm. The case was managed by local curative excision under local anaesthesia. On gross histopathology, the lesion showed squamous epithelium consisting of variable levels of acanthosis and hyperkeratosis, and focal parakeratosis which also shows focal ulceration and moderate to severe dysplasia and mixed inflammation consistent with papilloma. Histopathological examination has a role in differentiating the benign lesions like nipple papilloma from fibroepithelial stromal polyp of nipple and also helps in determining the presence of atypical hyperplasia, dysplasia or carcinoma in-situ.

Fibroepithelial Stromal Polyp as Low Back Lesion in 88-year-old Man: a Case Report

Fibroepithelial Stromal Polyp as Low Back Lesion in 88-year-old Man: a Case Report

Mesenchymal lesions of the vulva.

Mesenchymal lesions of the vulva include site-specific entities limited to the lower genital tract, as well as a range of non-site-specific tumors that are more common at extragenital sites. Site-specific lesions include fibroepithelial stromal polyp, cellular angiofibroma, angiomyofibroblastoma, and aggressive angiomyxoma. Non-site-specific tumors that may occur in the vulva include those of smooth muscle, skeletal muscle, vascular, neural, adipocytic, and uncertain differentiation. This review discusses both site-specific and non-site-specific vulvar mesenchymal lesions including non-neoplastic proliferations, benign neoplasms, locally aggressive neoplasms with a predilection for local recurrence, neoplasms of indeterminate biologic potential, and frankly malignant neoplasms with a high risk of distant metastasis and death. Accurate diagnosis is essential for proper management, and is facilitated by correlation with clinical findings and targeted application of immunohistochemical and molecular studies.

Clinical and epidemiological study of non-venereal genital diseases in females

<p class="abstract"><strong>Background:</strong> Dermatoses which are not sexually transmitted are referred to as non-venereal dermatoses of external genitalia. Venereal and non-venereal dermatoses tend to be confused and it is associated with guilt feeling in affected patients. The aim of the study was to study the incidence of non-venereal lesions of the genitalia and to know the incidence of non-venereal lesions of the genitalia in association with dermatoses of other parts of the body.</p><p class="abstract"><strong>Methods:</strong> This was a cross-sectional, clinical and observational study in 250 female patients attending dermatovenereology OPD of Vydehi Hospital, Bengaluru with non-venereal genital lesions for a period of 18 months. cases having venereal diseases were excluded from the study.<strong></strong></p><p class="abstract"><strong>Results:</strong> The study included 250 female patients with non-venereal genital lesions. Twenty-five different types of non-venereal dermatoses were observed. Inflammatory disorders were most common accounting for 128 patients (51.2%). Among inflammatory disorders lichen simplex chronicus was seen most followed by lichen sclerosus. Candidiasis was found to be more common among infections and infestations. Vitiligo was the commonest pigmentary disorder seen in our study. Other cases noted include epidermal inclusion cyst, Bartholin cyst and fibroepithelial stromal polyp. Pre malignant conditions like Bowenoid papulosis and malignant lesions like squamous cell carcinoma are also seen.</p><p class="abstract"><strong>Conclusions:</strong> This study helps in understanding the importance of diagnosis of non-venereal dermatoses and to differentiate it from venereal causes.</p><p> </p>

Large vulvar mass in young adult female

A 24-year-old African-American woman with no significant medical history presented with an enlarging mass on her right labium for two years. It had grown more rapidly in the past few months and occasionally bled. A gelatinous 5.5 × 6.5 cm polyp with surface ulceration on a 4 cm stalk was on the right labium majus (Figure 1). The patient was scheduled for surgical removal. Two clamps could be placed on the stalk before removing the lesion and using interrupted hemostatic sutures. Pathology report demonstrated a fibroepithelial stromal polyp (FSP) with surface ulceration and reactive atypia including koilocytic type changes (Figure 2). Human papillomavirus (HPV) testing on follow-up pap smear was negative. Fibroepithelial stromal polyp or “pseudosarcoma botryoides” were associated with elevated hormone levels and chronic inflammation. Due to the large size of this presentation, histologic evaluation was required to rule out angiomyxomas or other malignant conditions. There has been no recurrence to date.

Vulvovaginal fibroepithelial stromal polyp with myxoid stroma: A diagnostic dilemma on histology – Report of two cases

Genital stromal tumors are a rare and unique subset of soft-tissue tumors encountered in the vulvovaginal and inguinoscrotal region and this group includes fibroepithelial stromal polyp, superficial (cervicovaginal) myofibroblastoma, cellular angiofibroma, mammary-type myofibroblastoma, angiomyofibroblastoma, superficial angiomyxoma, and deep/aggressive angiomyxoma. The relative rarity and overlapping histomorphological and immunohistochemical features result in a diagnostic difficulty for the pathologists. Herein, we describe two cases of soft-tissue tumors in the vulvovaginal region presenting as polypoidal mass with detailed histopathology and immunohistochemical workup.

妊娠中に発症し増大した肛門線維上皮性間質ポリープと考えられた1例

妊娠中に発症し増大した肛門線維上皮性間質ポリープと考えられた1例

Genital soft tissue tumors.

Mesenchymal neoplasms of the vulvovaginal and inguinoscrotal regions are among the most diagnostically challenging specimens in the pathology laboratory owing largely to their unique intersection between general soft tissue tumors and relatively genital-specific mesenchymal tumors. Genital stromal tumors are a unique subset of soft tissue tumors encountered at this location, and this group includes fibroepithelial stromal polyp, superficial (cervicovaginal) myofibroblastoma, cellular angiofibroma, mammary-type myofibroblastoma, angiomyofibroblastoma and aggressive angiomyxoma. Aside from the striking morphologic and immunophenotypic similarity that is seen with these entities, there is evidence that a subset of genital stromal tumors may be linked genetically. This review will focus on simplifying this group of tumors and provide the pathologist or dermatopathologist with practical management information. Smooth muscle tumors of the external genitalia will also be discussed.

An unusual case of a large fibroepithelial stromal polyp presenting as a nipple mass

BackgroundFibroepithelial stromal polyps (FESP) are benign lesions that typically occur in the genital area and are known to represent a diagnostic challenge for pathologists. Not only do they have a spectrum of morphological changes that ranges from bland morphology to rather atypical appearances, but they also share morphological features with a number of benign and malignant lesions.This is a report of a rare presentation of a FESP of the breast.Case presentationWe describe an unusual case of a large polypoid mass arising from the nipple and connected to it by a long pedicle in a female of 45. The lesion comprised spindle and stellate shaped cells with bizarre stromal giant cells. The morphological and immunohistochemical diagnostic features are provided together with a discussion of possible mimics.ConclusionFESPs may occur in the female breast. It is important to differentiate the lesion from other benign and malignant spindle cell lesions particularly metaplastic carcinoma.

Giant fibroepithelial stromal polyp of the vulva: largest case reported

BackgroundFibroepithelial stromal polyps are site-specific mesenchymal lesions that are commonly found in the vulvovaginal region in premenopausal females. These polyps usually are less than 5 cm in diameter and are most commonly identified during routine gynecological examination. Although the stromal polyp is benign, its differential diagnosis includes some malignant vulva lesions making it critical to ensure that an accurate pathologic diagnosis is made.CaseWe present a case of a 21 year old female with a giant fibroepithelial stromal polyp of the vulva. Upon review of the literature this is the largest reported fibroepithelial stromal polyp to date.ConclusionFibroepithelial stromal polyps can grow as large as 390 grams and can be 18.5-cm in diameter. Microscopic evaluation of the polyp is critical in the exclusion of malignancy with this diagnosis.

Cellular Pseudosarcomatous Fibroepithelial Stromal Polyp of the Vagina during Pregnancy: A Lesion That Is Overdiagnosed as a Malignant Tumor

Fibroepithelial stromal polyp (FSP) is a benign lesion that can occur at various sites, including the lower female genital tract. In rare cases, however, it may exhibit hypercellularity, bizarre cytomorphological features, and atypical mitoses resulting in an overdiagnosis as a malignant tumor despite its benign clinical course. Recently, we experienced one case of a 30-year-old pregnant woman with cellular pseudosarcomatous FSP that was initially diagnosed as a malignant fibrous histiocytoma at a primary clinic. In addition to describing the rare features of this case, we wish to increase awareness about this benign lesion which will be essential for avoiding unnecessary radical surgery or chemoradiation treatment.

Prenatal sonographic findings associated with fibroepithelial stromal polyp of the vulva

Prenatal sonographic findings associated with fibroepithelial stromal polyp of the vulva

A Vulvar Fibroepithelial Stromal Polyp Appearing in Infancy

We present here a first case of vulvar fibroepithelial stromal polyp (vFSP) appearing in infancy, including previously undescribed papule as an early form of vFSP. A 7-month-old girl presented with a small (adzuki-sized), soft, erythematous papule in the right labium majus. The size of the lesion increased up to 2.3 cm in the following 7 months and exhibited cerebriform or frond-like configuration. The surgically removed polyp was characterized by the proliferation of bland spindle cells with tapered cytoplasm, and the diagnosis of vFSP was established. Twenty-one months after the first surgery, a recurrent polyp 2.0 cm in size was resected. No further recurrence has been observed in the 17 months since the second surgery.

Association of Psoriasis and Vulval Fibroepithelial Polyp

Fibroepithelial stromal polyps of the vulvovaginal region display a wide range of morphologic appearances. This morphologic spectrum allows the correct diagnosis to be made in some cases but when histology reveals unusual features, the lesion may be misinterpreted as malignant. We present a case of a 35-year-old woman with psoriasis who developed a 15-cm polypoid lesion localized in the left labium. The labial lesion was resected and no recurrence was detected 12 months after the initial treatment. Histologically, the lesion exhibited the characteristics of a fibroepithelial stromal polyp with focal myxoid areas and underlying vulval psoriasis disease. The clinical, microscopic, and immunohistochemical findings of this case suggest a fibroepithelial polyp of the vulva. This vulval lesion represents a unique example of giant fibroepithelial stromal polyp developed in association with psoriasis.

Pattern of non-venereal dermatoses of female external genitalia in South India

Non-venereal dermatoses tend to be confused with venereal diseases, which may be responsible for mental distress and guilt feelings in patients. We conducted the study to find the pattern of non-venereal dermatoses of female external genitalia and to correlate non-venereal dermatoses with various clinical parameters. The study included 120 female patients with non-venereal dermatoses of female external genitalia presenting over a period of 22 months from September 2005 to June 2007. The demographic characteristics and clinical findings were recorded. Cases having venereal diseases were excluded from the study. A total of nineteen non-venereal dermatoses were noted in the study. The most common non-venereal dermatoses were lichen sclerosus (26 cases or 21.7%), vitiligo (19 cases or 15.8%), lichen simplex chronicus (16 cases or 13.3%), and vulval candidiasis (11 or 9.2%). Other dermatoses included lymphedema, invasive squamous cell carcinoma, tinea cruris, psoriasis, furuncle, folliculitis, lichen planus, epidermal inclusion cyst, herpes zoster, irritant contact dermatitis, acrochordon, Bartholin cyst, fibroepithelial stromal polyp, molluscum contagiosum (autoinoculated), and streptococcal vulvitis. This study highlights the importance of diagnosing non-venereal dermatoses and refutes the general misconception that all vulval itching is the result of fungal infection. The two most common causes of vulval itching observed in the study were lichen sclerosus and lichen simplex chronicus.

Giant fibroepithelial stromal polyp of the vulva: extended field‐of‐view ultrasound and computed tomographic findings

Giant fibroepithelial stromal polyp of the vulva: extended field‐of‐view ultrasound and computed tomographic findings