Nasu Kaei, Okamoto Mamiko, Nishida Masakazu, Narahara Hisashi
Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Oita, Japan.
J Obstet Gynaecol Res. 2013 May;39(5):1095-7. doi: 10.1111/jog.12003. Epub 2013 Mar 17.
Endometriosis of the perineum and vulva is extremely rare, with the most common site being episiotomy scars. We report here a case of spontaneously developing perineal endometriosis successfully treated with local excision. A 39-year-old woman was admitted complaining of a painful vulvar lump with cyclic swelling. She had first noticed the mass 7 years before, and it had gradually increased in size. Gynecological examination showed a walnut-size, painful, subcutaneous mass in the left perineum. Magnetic resonance imaging revealed a multilobular cystic mass with inner hemorrhage, suggesting vulvar endometriosis. The patient was treated by local excision of the vulvar mass, and complete excision was achieved. The pathological diagnosis of the excised tissue was endometriosis. The patient is well without evidence of disease 5 months following the local excision. Spontaneous perineal and vulvar endometriosis is extremely rare. However, any lesion that evolves in response to the menstrual cycle should be considered endometriosis.
会阴和外阴子宫内膜异位症极为罕见，最常见的部位是会阴侧切瘢痕。我们在此报告一例经局部切除成功治疗的自发性会阴子宫内膜异位症病例。一名39岁女性因周期性肿胀的疼痛性外阴肿块入院。她7年前首次发现该肿块，且其大小逐渐增大。妇科检查发现左侧会阴有一个核桃大小、疼痛的皮下肿块。磁共振成像显示一个多叶囊性肿块伴内部出血，提示外阴子宫内膜异位症。患者接受了外阴肿块局部切除术，实现了完整切除。切除组织的病理诊断为子宫内膜异位症。局部切除术后5个月，患者情况良好，无疾病迹象。自发性会阴和外阴子宫内膜异位症极为罕见。然而，任何随月经周期演变的病变都应考虑为子宫内膜异位症。
