Large Vulvar Fibroepithelial Stromal Polyp With Superficial Vascular Thrombosis: A Case Report

The present case report concerns a postmenopausal patient who presented to the gynecological outpatient clinic of the hospital with a two-year history of a pedunculated mass located in the vulvar region, which had gradually increased in size. During the preceding six months, the patient reported discomfort and difficulty during ambulation and sitting, as well as intermittent mild vulvar pain not associated with any local trauma. Clinical examination revealed a pedunculated vulvar lesion with a maximum diameter of approximately 45 mm, oval-shaped, semi-firm in consistency, and non-tender on palpation. Based on the clinical findings, a strong presumptive diagnosis of a vulvar fibroepithelial stromal polyp was made, and surgical excision of the lesion was decided. Histopathological examination of the surgical specimen confirmed the diagnosis of a vulvar fibroepithelial stromal polyp with superficial dermal vascular thrombosis. The postoperative course was uneventful. No evidence of disease recurrence was observed six months following surgery. The patient remains under regular follow-up with annual clinical evaluations to date. This case report highlights the unusual occurrence of a vulvar fibroepithelial stromal polyp with superficial vascular thrombosis in a postmenopausal patient without a history of hormone replacement therapy or tamoxifen use. Additionally, the main risk factors are reviewed, and the contemporary diagnostic approach to this rare pathological entity is discussed, emphasizing the pivotal role of surgical management and the necessity of distinguishing it from malignant vulvar conditions.