Boreikaitė Evelina, Bilius Vytautas, Bumbul-Mazurek Elžbieta, Bumbulienė Žana
Clinic of Obstetrics and Gynecology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius University Hospital Santaros klinikos, Vilnius, Lithuania.
Clinic of Children Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius University Hospital Santaros klinikos, Vilnius, Lithuania.
Acta Med Litu. 2021;28(2):374-378. doi: 10.15388/Amed.2021.28.2.18. Epub 2021 Dec 22.
This is the first case describing vaginal papillomatosis with a fibroepithelial polyp of the vulva in a prepubertal girl and vaginal papillomatosis in her twin sister. Parents contacted pediatric urologist regarding their eight-year-old daughter (twin A), who had a growth next to the external urethral meatus. The girl was referred to a pediatric surgeon. The exophytic 3 cm long structure with necrosis on top was found. After obtaining informed consent from girl parents, pediatric surgeon removed the exophytic structure and perform cystoscopy and vaginoscopy for possible changes in the bladder and vagina. Cystoscopy findings were normal. On vaginoscopy, numerous macroscopic papillomatous structures were identified on the cervix and vaginal walls. Vaginal biopsies were performed on the areas affected by papillomatosis. Histopathologic examination showed a fibroepithelial polyp with a central fibrovascular core covered by squamous epithelium and vaginal squamous papillomatosis. The decision was made to perform vaginoscopy on her twin sister (twin B), too. On vaginoscopy, solitary small vaginal papillomas were also found. In this case manifestation of vaginal papillomatosis in twins might have been influenced by inheritance and the same bacterial and viral environment.
这是首例描述青春期前女孩外阴纤维上皮性息肉合并阴道乳头瘤病以及其孪生姐妹阴道乳头瘤病的病例。患儿父母就其8岁女儿(双胞胎A)尿道外口旁出现肿物一事联系了小儿泌尿科医生。该女孩被转诊至小儿外科医生处。发现了一个顶部有坏死的3厘米长的外生性结构。在获得女孩父母的知情同意后,小儿外科医生切除了该外生性结构,并进行了膀胱镜检查和阴道镜检查,以排查膀胱和阴道可能存在的病变。膀胱镜检查结果正常。在阴道镜检查中,在宫颈和阴道壁上发现了许多肉眼可见的乳头瘤样结构。对受乳头瘤病影响的区域进行了阴道活检。组织病理学检查显示为一个纤维上皮性息肉,其中心有纤维血管核心,表面覆盖鳞状上皮,同时伴有阴道鳞状乳头瘤病。随后也决定对其孪生姐妹(双胞胎B)进行阴道镜检查。在阴道镜检查中,也发现了孤立的小阴道乳头瘤。在该病例中,双胞胎中阴道乳头瘤病的表现可能受到遗传因素以及相同的细菌和病毒环境的影响。