Diagnosis and treatment of benign vulvar tumors

Abstract

Introduction. The vulvar region is a complex area because it has many elements, besides the skin, that are capable of producing a variety of benign tumors. The subepithelial fibrous stroma of the inferior female genital tract constitutes a differentiated mesenchyme, with myofibroblastic properties and a particular phenotype. Factors that favor the appearance of benign vulvar tumors can be classified into two groups with non-influential factors: such as age, race, pathological and heredocolateral history, vulvar atypia and with influential factors including: obesity, diabetes, smoking, compromised immunity, sedentarism, number of births and number of sexual partners. Also significant is the correlation between risk factors and the presence of HPV (human papillomavirus) that causes the appearance of high grade intraepithelial squamous lesions (HSIL, HPV dependent) and vulvar intraepithelial dysplasia. The conduct in diagnosing the vulvar lesion is to carefully inspect the affected region and the groin nodes, assessing the size of the lesion and the regional adenopathies. The main element of the diagnosis is vulvar biopsy with morphological confirmation. Treatment is performed by partial or radical vulvectomy. Aim of the study. Appreciation of the methods of diagnosis and treatment of benign vulvar tumors. Materials and methods.. In the study group were included 16 patients with benign vulvar tumors diagnosed and treated in IMSP IO from the Republic of Moldova during the years 2014- 2019. Results. Total enrolled: 16 patients. Distribution by age groups: 41-50 years - 5 patients (31.25%), 51-60 years - 5 patients (31.25%), 31- 40 years - 3 patients (18.75%), 61-70 years - 3 patients (18.75%). Based on the predisposing factors in the development of benign vulvar tumors, there were 7 cases of obesity (43.75%) and the presence of HPV virus type 6 and 11 in 9 patients (56.25%). According to the location: on the right labia - 6 patients (37.5%), and on the left labia - 10 patients (62.5%). In the examination of patients by ultrasonography we obtained in 10 patients a formation less than 5cm (62.5%), in 3 patients a formation of 6-10cm (18.75%) and in 3 patients a formation greater than 11 cm (18.75%). %). Based on the histological examination there were 5 cases of vulvar papilloma (31.25%), 8 cases of vulvar fibroma (50%) and 3 cases of vulva leukoplakia (18.75%). All patients underwent surgical treatment: partial vulvectomy -15 patients (93.75%) and radical vulvectomy - one patient (6.25%). Conclusions. 1. Obesity and the presence of HPV virus types 6 and 11 are some of the primary factors leading to the development of benign vulvar tumors 2. Histopathological examination represents the gold standard in the diagnosis of benign vulvar tumors. 3. Surgical treatment is the method of choice in the treatment of benign vulvar tumors.