Li Jia, Ijaz Iqra, Zhao Liang
Department of Gynecology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China.
Sichuan Provincial Center for Gynecological and Breast Diseases, Southwest Medical University, Luzhou, Sichuan, China; Department of Obstetrics & Gynecology Holy Family Hospital, Rawalpindi, Pakistan.
Int J Surg Case Rep. 2025 Jun;131:111104. doi: 10.1016/j.ijscr.2025.111104. Epub 2025 Mar 1.
Fibroepithelial polyps (FEPs) are benign mesenchymal skin tumors that usually occur in skin folds. FEPs clinically vary in appearance and size; typically, small papillomatous tumors grow <5 cm; however, large pedunculated forms can rarely grow >5 cm, called giant FEPs. In females during reproductive years, giant FEPs can occur in the genitals, commonly in vagina and rarely in the vulva and cervix.
The present case is of a 27-year-old sexually active nulliparous, who presented with the complaint of large, soft, single bag-like pedunculated growth from her left labium majus. It started as a tiny pedunculated growth of 0.5 cm more than five years ago and gradually enlarged to its present size, measuring 15 × 12 × 4 cm. The mass remained asymptomatic without any swelling, erosion or lymphadenopathy. The huge size and dragging sensation caused discomfort, so the patient sought for treatment. The mass was excised under local anesthesia, weighing 310 g, and pathologic examination was consistent with giant FEP. Over a long follow-up, no recurrence was noted; later patient also gave normal vaginal birth.
Even though the starting tiny size of the FEP is unnoticeable to the patient and not significant clinically. However, it is suggested that detailed clinical evaluation should be sought as soon possible to reduce the future discomfort due to slow growing nature and becoming huge in size over time. As in our case, large pedunculated FEP remained asymptomatic over years, typical nature of benign lesions. In present case excision was successful, however, It is important for clinicians to differentiate FEPs from malignancies, as early treatment can prevent complications such as ulceration.
FEPs may sometimes be misinterpreted for malignancy due to their appearance; however, clinical and pathologic expertise can help them differentiate. The treatment is very simple, and the patient should be counselled and encouraged to consider it at the earliest, so the erosion and ulceration of the tumor can be avoided. The recurrence is infrequent; however, follow-up is advised for an early intervention if it is encountered.
纤维上皮性息肉（FEP）是一种良性间充质皮肤肿瘤，通常发生于皮肤褶皱处。FEP在临床上外观和大小各异；典型的小乳头状肿瘤生长小于5厘米；然而，大的带蒂型肿瘤很少生长超过5厘米，称为巨大FEP。在育龄期女性中，巨大FEP可发生于生殖器部位，常见于阴道，很少见于外阴和宫颈。
本病例为一名27岁有性生活史的未生育女性，主诉左大阴唇有一个巨大、柔软、单个袋状带蒂肿物。它始于五年多前一个0.5厘米的小带蒂肿物，逐渐增大至目前大小，尺寸为15×12×4厘米。肿物一直无症状，无任何肿胀、糜烂或淋巴结病。巨大的尺寸和牵拉感引起不适，因此患者寻求治疗。肿物在局部麻醉下切除，重310克，病理检查符合巨大FEP。经过长期随访，未见复发；后来患者也顺产。
尽管FEP起初很小，患者不易察觉且临床上不显著。然而，建议尽早进行详细的临床评估，以减少因其生长缓慢且随时间变大而导致的未来不适。如我们的病例，大的带蒂FEP多年来一直无症状，这是良性病变的典型特征。在本病例中，切除成功，然而，临床医生将FEP与恶性肿瘤区分开来很重要，因为早期治疗可预防诸如溃疡等并发症。
FEP有时可能因其外观被误诊为恶性肿瘤；然而，临床和病理专业知识有助于鉴别。治疗非常简单，应向患者咨询并鼓励其尽早考虑治疗，以避免肿瘤的糜烂和溃疡。复发不常见；然而，建议进行随访，以便在复发时能早期干预。
