Vulva neoplasms are a form of pathology caused by abnormal cell division and corresponding tissue overgrowth in the area of the external genitalia. Almost any tissue structure located in the specified zone can produce such a process:
muscle;
epithelial;
fat;
connecting;
lymphoid.
The content of the article:
Types of benign neoplasms of the vulva
Symptoms of benign neoplasms of the vulva
Diagnosis of benign neoplasms of the vulva
Treatment of benign neoplasms of the vulva
Prognosis for benign neoplasms of the vulva
Neoplasms of the vulva
The following possible areas of the appearance of vulvar neoplasms are distinguished:
pubis;
large labia;
labia minora;
clitoris;
back spike;
the external opening of the urethra.
The most common fibroids and fibroids of the vulva. Both types belong to benign tumors. Among the malignant neoplasms of the vulva, squamous cell carcinoma is more common than others.
Benign neoplasms of the vulva have the following characteristics:
they grow slowly;
do not give metastases to other organs;
do not germinate into nearby organs;
squeeze neighboring organs with strong growth;
they have a clear border.
The main danger of neoplasms of the vulva (as, indeed, of any other organs) is that they continue to progress even after the elimination of the factors that provoked their appearance.
Types of benign neoplasms of the vulva
As already noted, neoplasms of the vulva can be both benign and malignant. Let’s consider what types of benign neoplasms of the vulva are known to modern gynecology.
Myoma of the vulva. It is a neoplasm, the structure of which is formed by muscle fibers. There are two types of it:
rhabdomyoma — fibroids formed by striated fibers;
leiomyoma is a fibroid consisting of smooth muscle fibers.
Among the main characteristics of this type of neoplasm, it is worth highlighting:
lack of connection with surrounding tissues;
mobility;
dense elastic consistency.
Most often, fibroids are found in the depths of the muscles of the labia majora.
Fibroma of the vulva. It is a formation of mature fibrous structures of connective tissue. In some cases, it is represented by bundles of collagen fibrils. Distinctive characteristics of vulvar fibroma:
absence of adhesions with surrounding tissues;
the presence of a leg or base;
slow growth;
the consistency determined by the degree of cytoplasm compaction and the location of collagen bundles.
Usually fibroma is found in the depth of the muscles of the labia majora. In some cases, its localization occurs in front of the vagina.
Fibromyoma of the vulva. This neoplasm combines the signs of the two previous ones and originates in the muscles of the large ligament.
Vulvar papilloma (condyloma). This formation from the integumentary epithelium is always associated with the human papillomavirus. It has a fibroepithelial structure and is often accompanied by hyperpigmentation. Its characteristics:
dark brown color (in some cases — whitish);
wide base or thin leg;
single or multiple distribution;
appearance of papillary overgrowth;
bulging outwards.
Papilloma is localized, as a rule, in the vestibule of the vagina or on the labia majora. Its danger lies in the high risk of degeneration into a malignant tumor after spreading to the vaginal mucosa.
Lipoma of the vulva. This neoplasm is formed by a fatty structure, sometimes with admixtures of connective tissue (in this case, a fibrolipoma is obtained). Its signs:
round shape;
the presence of a pronounced capsule;
slight mobility;
soft consistency.
The lipoma is located most often on the labia majora or on the pubis.
Lymphagioma of the vulva. This formation with a multi-cavity structure is represented by lymphoid tissue. It looks like a juicy, fine-grained nodule. This tumor is characterized by:
bluish tint;
the presence of dense inclusions;
the content of protein effusion;
soft consistency.
In most cases, lymphagioma is localized in the labia majora.
Myxoma of the vulva. This tumor is formed by mesenchyme — connective germ tissue, which forms directly connective and muscle tissue. Its signs:
yellowish-white color;
rounded contours;
the presence of a capsule;
gelatinous consistency.
Myxoma is usually found in the subcutaneous layer of the pubis or labia majora. This disease is more often diagnosed in post-menopausal women.
Hydroadenoma of the vulva. This neoplasm, emanating from the sweat glands, is a multiple nodular rash, arranged symmetrically. It is characterized by:
pinkish, yellowish or brown tint;
round or oval shape;
the presence of cystic cavities.
There is a hydroadenoma in the area of the labia majora or pubis.
Vulvar hemangioma. It is the formation of a capillary or cavernous structure emanating from the vessels of the mucous membrane and skin. Such a tumor looks like a cyanotic, and sometimes a red node protruding above the surface. It is dangerous with the risk of spreading to the tissues of the internal genitals — the vagina and uterus.
Symptoms of benign neoplasms of the vulva
As long as the education does not sufficiently increase in size, a woman may not notice it. As they grow, they protrude outward, stretching the adjacent tissues. As a result, discomfort occurs:
sensation of a foreign body in the perineum;
unpleasant sensations during sexual intercourse;
inconveniences when driving.
If the tumor is damaged, symptoms such as:
inflammation;
suppuration;
the appearance of ulcers;
contact bleeding;
violation of urination.
The latter is due to compression of the urethra by a growing formation.
Developing neoplasms of the vulva usually rise in the form of swelling above the skin. If blood circulation is disrupted in it or necrosis begins, then the woman begins to experience pain.
Diagnosis of benign neoplasms of the vulva
Only a gynecologist can make an appropriate diagnosis and determine the type of neoplasm. Given that they can develop asymptomatically, only regular examinations by a specialist can track the disease at an early stage.
Diagnosis begins with the collection of anamnesis. The doctor finds out:
patient’s complaints (discomfort, pain, discharge);
the time of their appearance;
the intensity of their manifestation;
the presence of gynecological diseases suffered in the past;
the presence of pregnancies, abortions, childbirth and operations;
a picture of menstrual function (cycle stability, soreness, profusion).
Next comes a gynecological examination, which necessarily includes a bimanual examination. In addition to standard gynecological manipulations, you may need:
transvaginal ultrasound;
vulvoscopy — examination of the external genitalia using a microscope (in some cases — contactless);
vaginal examination;
colposcopy or vaginoscopy is a study of the vagina and the part of the cervix that is close to it.
These methods allow you to make sure that the tumor has not spread from the external genitals to the internal ones, and if it has happened, how much.
If the doctor decides that the neoplasm risks being reborn from benign to malignant, then he will take a fragment of it and conduct a histological examination. In this case, the help of not an ordinary gynecologist, but a gynecologist-oncologist is required.
Treatment of benign neoplasms of the vulva
If the doctor is convinced that the vulva neoplasm is benign, it is unlikely that he will immediately prescribe treatment. Usually, the tumor is left under observation, provided that it does not cause inconvenience to the patient and does not progress in growth.
Indications for the removal of neoplasms surgically may be:
aesthetic discomfort;
symptomatic course of the disease;
tumor growth;
the risk of tissue structure changes.
Methods of removal of vulvar neoplasms have some features that depend on their types and localization:
The tumor located deep in the tissue is subject to peeling, followed by suturing of the bed.
The formation having a leg is excised at the base.
Fibroma removal requires a myomectomy.
A neoplasm located close to the urethra is removed with the involvement of a urologist in the operation.
Removal of the external genitalia directly, chemotherapy and radiation therapy are provided only in case of detection of malignant neoplasms. With the benign nature of tumors, such radical interventions are not required.
Prognosis for benign neoplasms of the vulva
Benign neoplasms of the vulva can pose a danger only if they acquire a malignant character. However, this happens quite infrequently. Thus, they do not entail a great risk to life and health.
The re-occurrence of neoplasms is possible, especially if we are talking about papillomas. To prevent this, antiviral treatment should be carried out after removal.
In addition, there is a risk of injury during the operation.
