[GYNE] BENIGN TUMORS OF THE VULVA AND VAGINA

True or False. Vulvar tumors are more common than vaginal tumors

True

Vulva has hair and glands which can harbor lesions

Main symptom of skene’s gland

Pain and terminal dysuria

Most common among small vulvar cysts

Epidermoid inclusion cysts

Most common benign solid tumor of vulva

Fibroma

Most common mesoderm-derived benign tumor

Lipoma

More commonly known as a skin tag

Fibroepithelial tumor

Location of Bartholin’s cysts

5 and 7 o clock position

Why is there terminal dysuria in skene’s gland cyst?

Due to pressure to the urethral meatus

Location of skene’s duct cyst

Anterior vaginal wall along the distal urethra

How to differentiate urethral diverticula and skene’s duct cyst?

No fluid production from urethral meatus

Treatment of skene’s gland cyst

Excision

Conservative management if asymptomatic

Appearance of epidermal inclusion cyst

Yellowish round cystic structure

Location of an epidermoid inclusion cyst

Posterior vaginal wall

Type of nevi that has the greatest potential for malignant transformation

Junctional and Dysplastic Nevus

Location of Vulvar milial cysts

Hair bearing growing areas

Etiology of epidermoid cysts

Blocked sebaceous gland

Treatment for epidermoid cysts

Prick or Puncture

No Treatment - if asymptomatic and non-inflamed

Antibiotic - Cloxacillin and Cephalosporins and Amoxicillin

Excision - Recurrent infection or painful cysts

Treatment of fibroma

Excision

Difference of Fibroma from a Lipoma

Fibroma: firm

Lipoma: soft

Most common location of lipoma

Peri-clitoris

Within labia majora

Most common symptoms of vulvar endometriosis

Pain
Introital Dyspareunia

Treatment of endometriosis

Wide excision and laser vaporization

Location of Bartholin’s cyst aside from clock position

Sybperineal space

Between hymen and posterior fourchette

How do we rule out Bartholin adenocarcinoma in a patient who is 40 years old?

Excision

Treatment: Skin tag or fibroepithelial polyp

Excision

Treatment: Hemangioma. When is excision with electrocautery done?

To know which vessels caused the malformation

Treatment: Hemangioma (asymptomatic)

No Tx

Treatment: Hemangioma (large bleeding and infected)

Subtotal resection

Treatment: Hemangioma (bleeding)

Cryosurgery. sclerotherapy, lasers

Polypoid cystic structure along the lateral vaginal wall

Epidermal inclusion cyst

Also known as mesonephric or mullerian cyst

Gartner’s duct cyst