Tags

Type your tag names separated by a space and hit enter

Massive vulval edema secondary to obesity and immobilization: a potential mimic of aggressive angiomyxoma.
Int J Gynecol Pathol. 2008 Jul; 27(3):447-52.IJ

Abstract

We report 2 cases of surgically resected vulval masses in women aged 27 and 40 years. One patient was wheelchair bound and the other was obese, both presented with bilateral vulvar swelling. One specimen measured 45 cm in maximum dimension and the other 5 cm and were described as grossly edematous or gelatinous. Histologically, in both cases, there was edema of the skin overlying the lesion. The lesion itself consisted of markedly edematous connective tissue with widely separated bland spindle-shaped cells and numerous dilated vascular channels, sometimes surrounded by cuffs of lymphocytes and plasma cells. In the larger of the 2 specimens, underlying edematous adipose tissue was present. To some extent, the appearances, especially the morphological features, mimicked aggressive angiomyxoma because of the presence of a mass, the lack of circumscription, the hypocellular, edematous appearance, and the presence of numerous vascular channels. However, a combination of clinical and pathological features, including bilateralism, lack of a true myxoid stroma, the presence of perivascular cuffs of lymphoid cells, and lack of staining with estrogen receptor, is against aggressive angiomyxoma. The appearances were interpreted as those of massive edema. In one case, there was recurrence of the mass after surgery. There has been a single previous report of a similar vulvar case in a quadriplegic female patient and of similar cases involving the upper and lower extremities of obese patients. Clinicians and pathologists should be aware of the existence of this lesion, which is likely due to lymphatic obstruction and lymphedema secondary to immobilization and obesity.

Authors+Show Affiliations

Department of Pathology, Royal Group of Hospitals Trust, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland. glenn.mccluggage@belfasttrust.hscni.netNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

18580326

Citation

McCluggage, W Glenn, et al. "Massive Vulval Edema Secondary to Obesity and Immobilization: a Potential Mimic of Aggressive Angiomyxoma." International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists, vol. 27, no. 3, 2008, pp. 447-52.
McCluggage WG, Nielsen GP, Young RH. Massive vulval edema secondary to obesity and immobilization: a potential mimic of aggressive angiomyxoma. Int J Gynecol Pathol. 2008;27(3):447-52.
McCluggage, W. G., Nielsen, G. P., & Young, R. H. (2008). Massive vulval edema secondary to obesity and immobilization: a potential mimic of aggressive angiomyxoma. International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists, 27(3), 447-52. https://doi.org/10.1097/PGP.0b013e31816017a7
McCluggage WG, Nielsen GP, Young RH. Massive Vulval Edema Secondary to Obesity and Immobilization: a Potential Mimic of Aggressive Angiomyxoma. Int J Gynecol Pathol. 2008;27(3):447-52. PubMed PMID: 18580326.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Massive vulval edema secondary to obesity and immobilization: a potential mimic of aggressive angiomyxoma. AU - McCluggage,W Glenn, AU - Nielsen,G P, AU - Young,Robert H, PY - 2008/6/27/pubmed PY - 2008/8/30/medline PY - 2008/6/27/entrez SP - 447 EP - 52 JF - International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists JO - Int. J. Gynecol. Pathol. VL - 27 IS - 3 N2 - We report 2 cases of surgically resected vulval masses in women aged 27 and 40 years. One patient was wheelchair bound and the other was obese, both presented with bilateral vulvar swelling. One specimen measured 45 cm in maximum dimension and the other 5 cm and were described as grossly edematous or gelatinous. Histologically, in both cases, there was edema of the skin overlying the lesion. The lesion itself consisted of markedly edematous connective tissue with widely separated bland spindle-shaped cells and numerous dilated vascular channels, sometimes surrounded by cuffs of lymphocytes and plasma cells. In the larger of the 2 specimens, underlying edematous adipose tissue was present. To some extent, the appearances, especially the morphological features, mimicked aggressive angiomyxoma because of the presence of a mass, the lack of circumscription, the hypocellular, edematous appearance, and the presence of numerous vascular channels. However, a combination of clinical and pathological features, including bilateralism, lack of a true myxoid stroma, the presence of perivascular cuffs of lymphoid cells, and lack of staining with estrogen receptor, is against aggressive angiomyxoma. The appearances were interpreted as those of massive edema. In one case, there was recurrence of the mass after surgery. There has been a single previous report of a similar vulvar case in a quadriplegic female patient and of similar cases involving the upper and lower extremities of obese patients. Clinicians and pathologists should be aware of the existence of this lesion, which is likely due to lymphatic obstruction and lymphedema secondary to immobilization and obesity. SN - 1538-7151 UR - https://www.unboundmedicine.com/medline/citation/18580326/Massive_vulval_edema_secondary_to_obesity_and_immobilization:_a_potential_mimic_of_aggressive_angiomyxoma_ L2 - http://dx.doi.org/10.1097/PGP.0b013e31816017a7 DB - PRIME DP - Unbound Medicine ER -