K.6.1 Vulval tumour

• The specimen of a lump at the vulva of a 21 year old female patient who presented with a history of a painful swelling at the vulva of 3 months duration.
• Clinical examination showed a large fleshy growth of the left labium majus, with haemorrhage into it.
• At surgery the growth was shelled out of its covering.
• The specimen shows an oval shaped firm lesion.
• The surface is lobulated, with patchy, dark (haemorrhagic) areas.
• The cut section has a solid, white appearance, and is lobulated.
• Lobules are of varying sizes.
• Some of the small lobules have a whorled appearance.
• A large area of organized blood and many haemorrhages were seen on cut section.
• Differential diagnosis include

                     Hidradenoma

                     Chronic bartholin cyst

                     Fibroma of the vulva

• Histology confirmed a Leiomyoma of the vulva.