Idiopathic chronic granulomatous vulvitis and related diagnostic and treatment conundrum

Three years ago, a woman in her late 30s presented with huge masses in the lower genital tract region, including bilateral labia majora, labia minora and the gluteal region. The patient had had many antimicrobial, antiprotozoal, steroid and topical antibiotic treatments. The patient was misdiagnosed and treated for metastatic Crohn's disease, but there was no improvement. The patient underwent extensive local excision of the lesions and was identified with a deep aggressive angiomyxoma; however, the tumors recurred. Her clinical condition deteriorated, and she was brought to this institution. This area was biopsied, and the results were suggestive of non-necrotising granulomatous disease. Labial and gluteal lesions were surgically excised, followed by primary closure of the operative site. The patient has undergone regular monitoring and has not experienced a recurrence.