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BMJ Case Reports Dec 2022Although uncommon, vaginal fibroepithelial polyps can present as prolapsing vaginal tissue, causing discomfort and anxiety. Surgical excision of the polyps can provide a...
Although uncommon, vaginal fibroepithelial polyps can present as prolapsing vaginal tissue, causing discomfort and anxiety. Surgical excision of the polyps can provide a minimally invasive solution. In this case, we describe a nulliparous female in late adolescence who presented for evaluation of tissue protruding through the vagina. On exam, a 5×4 cm fibroepithelial polyp was extending from the distal posterior vagina on a broad stalk. Successful transperineal surgical excision was performed. Fibroepithelial polyps, although uncommon, can be a cause for prolapsing vaginal tissue and should be part of the differential diagnosis, especially in patients who have no risk factors for pelvic organ prolapse. They can be excised vaginally, alleviating symptoms and distress. Because they sometimes recur, continued surveillance with gynaecological exams is recommended.
Topics: Humans; Female; Neoplasm Recurrence, Local; Pelvic Organ Prolapse; Neoplasms, Squamous Cell; Vaginal Neoplasms; Polyps
PubMed: 36549754
DOI: 10.1136/bcr-2022-250967 -
International Journal of Surgical... Feb 2017Although rare, pregnant women can present with fibroepithelial polyps of the vagina. Most likely hormonally related, these polyps have been described in various...
BACKGROUND
Although rare, pregnant women can present with fibroepithelial polyps of the vagina. Most likely hormonally related, these polyps have been described in various locations of the lower female genital tract. They can be mistaken for malignant lesions due to hypercellularity and cytologic atypia.
CASE
We describe the case of a 31-year-old woman who presented with a polyp of the vagina during a postpartum visit.
RESULTS
Atypical cells were seen in hypercellular areas of the stroma of the polyp.
CONCLUSION
A pitfall to avoid is classifying these benign lesions as malignant based on atypical histopathology.
Topics: Adult; Biomarkers, Tumor; Desmin; Female; Humans; Immunohistochemistry; Polyps; Pregnancy; Pregnancy Complications, Neoplastic; Receptors, Estrogen; Receptors, Progesterone; Vaginal Neoplasms; Vimentin
PubMed: 27571791
DOI: 10.1177/1066896916666676 -
European Journal of Obstetrics,... May 2021To provide an updated practice guideline for the management of patients with endometrial polyps. (Review)
Review
OBJECTIVE
To provide an updated practice guideline for the management of patients with endometrial polyps.
MATERIALS AND METHODS
A committee of six expert researchers draw the recommendations according to AGREE II Reporting Guideline. An electronic search was performed querying the following databases MEDLINE (accessed through PubMed), Scopus, PROSPERO, EMBASE, CINAHL, Cochrane Library (including the Cochrane Database of Systematic Reviews), Scielo.br, Google Scholar, from inception to May 2020. A combination of text-words and Medical Subject Headings (MeSH) regarding endometrial polyps, diagnosis, management and treatment was used. Trials were assessed for methodologic rigor and graded using the United States Preventive Services Task Force classification system.
RECOMMENDATIONS
Transvaginal ultrasonography (TVUS) should be the imaging modality of choice for the detection of endometrial polyps in woman of fertile age (level B). Its accuracy increases when color-doppler, 3D investigation and contrast are used (level B). Dilation and Curettage (D&C) should be avoided for the diagnosis and management of polyps (level A). In office hysteroscopy showed the highest diagnostic accuracy in infertile patients with suspected endometrial polyps (level B). Polyps might alter endometrial receptivity, and embryo implantation reducing pregnancy rates (level C). Hysteroscopic polypectomy is feasible and safe with negligeble risk of intrauterine adhesion formation (level B). Polypectomy does not compromise reproductive outcomes from subsequent IVF procedures but the removal of polyps as a routine practice in sub-fertile women is not currently supported by the evidence (level B). Cost-effectiveness analysis suggest performing office polypectomy in women desiring to conceive (level B). Saline infused sonohysterography is highly accurate in detecting polyps in asymptomatic postmenopausal women (level B). Postmenopausal women with vaginal bleeding and suspected endometrial polyp should be offered diagnostic hysteroscopy with hysteroscopic polypectomy if endometrial polyps are present (level B). In-office hysteroscopy has the highest diagnostic accuracy with high cost-benefits ratio for premalignant and malignant pathologies of the uterine cavity (level B). Due to risk of malignancy, histopathological analysis of the polyp is mandatory (level B). Blind D&C should be avoided due to inaccuracy for the diagnosis of focal endometrial pathology (level A). Expectant management is not recommended in symptomatic patients especially in postmenopausal women (level B). In case of atypical hyperplasia or carcinoma on a polyp, hysterectomy is recommended in all post-menopausal patients and in premenopausal patients without desire of future fertility (level B). Asymptomatic endometrial polyps in postmenopausal women should be removed in case of large diameter (> 2 cm) or in patients with risk factors for endometrial carcinoma (level B). Excision of polyps smaller than 2 cm in asymptomatic postmenopausal patients has no impact on cost-effectiveness or survival (level B). Removal of asymptomatic polyps in premenopausal women should be considered in patients with risk factors for endometrial cancer (level B).
Topics: Endometrial Neoplasms; Female; Humans; Hysteroscopy; Polyps; Pregnancy; Systematic Reviews as Topic; Uterine Diseases; Uterine Neoplasms
PubMed: 33756339
DOI: 10.1016/j.ejogrb.2021.03.017 -
BMJ Case Reports Jun 2022
Topics: Female; Humans; Neoplasms, Fibroepithelial; Polyps; Vagina
PubMed: 35710231
DOI: 10.1136/bcr-2022-250076 -
BJR Case Reports Mar 2022A fibroepithelial stromal polyp is a benign soft tissue tumour that can occur in the vagina, vulva and uterine cervix. Magnetic resonance imaging (MRI) findings have...
A fibroepithelial stromal polyp is a benign soft tissue tumour that can occur in the vagina, vulva and uterine cervix. Magnetic resonance imaging (MRI) findings have been reported in patients with vulvar fibroepithelial stromal polyps, not in those with vaginal polyps. We present MRI findings of vaginal fibroepithelial stromal polyp in a postmenopausal female. A 1 to 2 cm firm vaginal mass arising from the left side of the vaginal wall with hypointense signal changes on T1W MRI was identified. A well-defined vaginal mass (1 cm diameter) was detected with inhomogeneous signal intensity on T2W images. However, a major portion had high signal intensity on diffusion-weighted images. A benign vaginal lesion with oedematous changes or myxoid degeneration was suspected. Vaginal resection was performed, and fibroepithelial stromal polyp was pathologically diagnosed. MRI may be a useful non-invasive modality for preoperatively diagnosing vaginal fibroepithelial stromal polyps.
PubMed: 36177268
DOI: 10.1259/bjrcr.20210189 -
CMAJ : Canadian Medical Association... May 2023
Topics: Female; Humans; Endometriosis; Vaginal Diseases; Polyps
PubMed: 37127308
DOI: 10.1503/cmaj.220466 -
Indian Journal of Pediatrics Jan 2023
Topics: Female; Humans; Polyps; Vagina; Pelvis; Connective Tissue Diseases
PubMed: 36443514
DOI: 10.1007/s12098-022-04406-7 -
Indian Journal of Pathology &... 2012Schistosomiasis still represents a major threat to women's health in many developing countries. The frequency in developed countries is increasing among immigrants and...
Schistosomiasis still represents a major threat to women's health in many developing countries. The frequency in developed countries is increasing among immigrants and tourists who have a history of freshwater exposure in endemic areas. This is a case of 43-year-old immunocompetent Egyptian woman presented by abnormal vaginal bleeding. The gynecological examination revealed an endocervical polyp measuring 3 x 2 x 1 cm. Polypectomy was done. Histopathological examination revealed several granulomas containing viable eggs of Schistosoma hematobium. Schistosomiasis is rarely presented with endocervical polyp. In developing countries, schistosomiasis may be considered in differential diagnosis of patient with endocervical polyp.
Topics: Adult; Animals; Egypt; Female; Histocytochemistry; Humans; Polyps; Schistosoma haematobium; Schistosomiasis haematobia; Uterine Hemorrhage; Uterus
PubMed: 23032837
DOI: 10.4103/0377-4929.101750 -
European Journal of Pediatrics May 2008Vaginal fibroepithelial polyp is a rare lesion, and although benign, it can be confused with malignant connective tissue lesions. Treatment is simple excision, and...
Vaginal fibroepithelial polyp is a rare lesion, and although benign, it can be confused with malignant connective tissue lesions. Treatment is simple excision, and recurrence is extremely uncommon. We report a case of a newborn with vaginal fibroepithelial polyp. The authors suggest that vaginal polyp must be considered in the evaluation of interlabial masses in prepubertal girls.
Topics: Diagnosis, Differential; Female; Follow-Up Studies; Humans; Infant, Newborn; Polyps; Urogenital Surgical Procedures; Vaginal Neoplasms
PubMed: 17619202
DOI: 10.1007/s00431-007-0524-x