Giant vulvar verruciform xanthoma can mimic a common vulvar mass, genital warts

Published:November 25, 2016DOI:
      A 35-year-old woman who denied any previous sexual activity presented with an extremely large vulvar mass that had slowly grown for 25 years. The patient reported vulvar discomfort from the mass effect but no itching or pain. The vulvar mass consisted of 9 yellowish flesh-colored, cauliflower-shaped lumps, 115 × 90 mm diameter in total (Figure 1, A). The presentation initially suggested genital warts, so a human papillomavirus (HPV) DNA test with biopsy was performed. The results from polymerase chain reaction for both 9 types of low-risk and 19 types of high-risk HPV were all negative. The pathological diagnosis for the biopsy specimen was verruciform xanthoma.
      Figure thumbnail gr1
      Figure 1Clinical features of vulvar verruciform xanthoma
      Clinical manifestation of giant vulvar verruciform xanthoma with mucosal xanthomas. A, Giant vulvar mass consisted of 9 yellowish flesh-colored, cauliflower-shaped lumps. These 9 lumps were separated from each other and pedunculated from mons pubis, labium majora and minora. Thorough examination revealed typical orange hue of xanthoma. B, Small xanthoma originating from upper right side of vulva and growing toward anal canal (arrow). C, Multiple yellowish patch of mucosal xanthoma on hymen and vestibule (dotted circles). D, Immediate postoperative state. E. External genitalia on gross examination were free of disease at 2-month follow-up.
      Lee. Giant vulvar verruciform xanthoma can mimic genital warts. Am J Obstet Gynecol 2017.
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        • Shafer W.G.
        Verruciform xanthoma.
        Oral Surg Oral Med Oral Pathol. 1971; 31: 784-789
        • Ijichi A.
        • Mitoma C.
        • Yasukochi Y.
        • Uchi H.
        • Furue M.
        Vulvar verruciform xanthoma developing in acquired lymphangioma circumscriptum.
        J Dermatol. 2016; ([In press])
        • Fite C.
        • Plantier F.
        • Dupin N.
        • Avril M.F.
        • Moyal-Barracco M.
        Vulvar verruciform xanthoma: ten cases associated with lichen sclerosus, lichen planus, or other conditions.
        Arch Dermatol. 2011; 147: 1087-1092
        • Frankel M.A.
        • Rhodes H.E.
        • Euscher E.D.
        Verruciform xanthoma in an adolescent: a case report.
        J Low Genit Tract Dis. 2012; 16: 70-74
        • Xu X.L.
        • Huang L.M.
        • Wang Q.
        • Sun J.F.
        Multiple verruciform xanthomas in the setting of congenital hemidysplasia with ichthyosiform erythroderma and limb defects syndrome.
        Pediatr Dermatol. 2015; 32: 135-137
        • Santa Cruz D.J.
        • Martin S.A.
        Verruciform xanthoma of the vulva: report of two cases.
        Am J Clin Pathol. 1979; 71: 224-228
        • Cumberland L.
        • Dana A.
        • Resh B.
        • Fitzpatrick J.
        • Goldenberg G.
        Verruciform xanthoma in the setting of cutaneous trauma and chronic inflammation: report of a patient and a brief review of the literature.
        J Cutan Pathol. 2010; 37: 895-900
        • Reich O.
        • Regauer S.
        Recurrent verruciform xanthoma of the vulva.
        Int J Gynecol Pathol. 2004; 23: 75-77