Exploring Vulval Fibroadenoma: A Rare Entity

Vulval fibroadenoma is a rare benign neoplasm mimicking mammary fibroadenoma, with limited cases reported earlier. Its origin is still debatable, linked to either ectopic mammary tissue or specialized anogenital glands. Similar to breast fibroadenoma, it usually presents as a painless, firm, well-circumscribed mass and responds to hormonal changes during menstruation, pregnancy, or lactation. Its diagnosis relies on core needle biopsy or fine needle aspiration cytology, while treatment involves surgical excision with clear margins to prevent a recurrence. We report a 33-year-old woman with a painless pedunculated vulval mass hanging from the right labia majora. Ultrasonography showed a heterogeneous lesion with mild internal vascularity. Fine needle aspiration cytology was advised, but the patient opted for immediate removal. Excised mass on microscopy revealed glandular and stromal hyperplasia with cuboidal cells resting on a myoepithelial layer, and stroma contained spindle cells arranged in fascicles with elongated nuclei and moderate cytoplasm along with peri-canalicular pattern, suggestive of a fibroadenoma. No recurrence was noted during a one-year follow-up. This case of vulval fibroadenoma emphasizes the importance of considering ectopic breast tissue or mammary-like anogenital glands in the differential diagnosis of vulval masses. Although there are more case reports, it still remains uncommon with varied presentations, necessitating further discussion.