Ancient schwannoma of the vulva

Ancient schwannoma, a variant of schwannoma (previously termed neurilemoma), arises from the Schwann cells of the nerve sheath. It presents with swelling, pain, or paresthesia.

A 53-year-old woman presented with a history of a left vulvar swelling, which had been present for many years. The tumor was slowly increasing in size and affected activities such as sitting and walking. Occasionally, she experienced a burning sensation at the site of the swelling. Surgical excision was undertaken, and histology demonstrated an ancient schwannoma.

The characteristic histological appearance seen in ancient schwannoma should prevent the erroneous diagnosis of a malignant tumor. Malignant change is exceedingly rare. Treatment is complete surgical excision.