Multiple Tubulovillous Adenomas of the Vulva

Abstract

Enteric-type lesions are rare in the female genital tract. We report the first case of multiple vulvar tubulovillous adenomas with transformation into adenocarcinoma. A 31-year-old woman presented with recurrent vulvar polypoid lesions resembling condylomas that were excised. These tumors were characterized by their tubulovillous architecture and intestinal differentiation, with columnar epithelium, goblet cells, and Paneth cells. As in their colonic counterpart, the degree of dysplasia was evaluated. The lesions consisted of 3 low-grade adenomas and 1 adenocarcinoma with superficial invasion. After 15 months, there is no sign of recurrence. The clinical presentation, pathological findings, differential diagnoses, and pathogenesis are discussed.