OJOG  Vol.8 No.4 , April 2018
A Large Vaginal Bulge Might Not Be a Genital Prolapse
Vaginal tumors, whether benign or malignant, are rare. They include fibroepithelial polyps (FEPs), which are benign lesions originating in mesenchymal cells, comprised of a core of connective tissue covered by squamous epithelium. They are usually small and asymptomatic. When symptomatic or very large, they may cause bleeding, genital discomfort or the presence of a bulge in the vagina. In the last case, they may be mistaken for a genital prolapse. Although their physiopathology is still not clearly understood, the presence of hormonal receptors and the occurrence of FEPs during the use of hormone therapy or pregnancy suggest that changes in the stroma of these lesions may be induced by hormones. We report on the case of a patient who presented with a vaginal bulge and was referred to the urogynecology outpatient ward with a diagnosis of genital prolapse, which had actually a large fibroepithelial polyp on the posterior vaginal wall.
Cite this paper
Meletti, N. , Fialho, S. , Rodrigues, F. and Faria, C. (2018) A Large Vaginal Bulge Might Not Be a Genital Prolapse. Open Journal of Obstetrics and Gynecology, 8, 362-367. doi: 10.4236/ojog.2018.84040.
[1]   Haylen, B.T., de Ridder, D., Freeman, R.M., Swift, S.E., Berghmans, B., Lee, J., et al. (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) Joint Report on the Terminology for Female Pelvic Floor Dysfunction. International Urogynecology Journal, 21, 5-26.

[2]   Halvorsen, T.B. and Johannesen, E. (1992) Fibroepithelial Polyps of the Vagina: Are They Old Granulation Tissue Polyps? Journal of Clinical Pathology, 45, 235-240.

[3]   Rollason, T.P., Byrne, P. and Williams, A. (1990) Immunohistochemical and Electron Microscopic Findings in Benign Fibroepithelial Vaginal Polyps. Journal of Clinical Pathology, 43, 224-229.

[4]   Sharma, S., Albertazzi, P. and Richmond, I. (2006) Vaginal Polyps and Hormones— Is There a Link? A Case Series. Maturitas, 53, 351-355.

[5]   Song, J.S., Song, D.E., Kim, K.-E. and Ro, J.Y. (2012) Cellular Pseudosarcomatous Fibroepithelial Stromal Polyp of the Vagina during Pregnancy: A Lesion That Is Overdiagnosed as a Malignant Tumor. Korean Journal of Pathology, 46, 494-498.

[6]   O’Quinn, A.G., Edwards, C.L. and Gallager, H.S. (1982) Pseudosarcoma Botryoides of the Vagina in Pregnancy. Gynecologic Oncology, 13, 237-241.

[7]   Nucci, M.R. (2003) Application of Biomarkers in the Diagnosis and Differential Diagnosis of Uterine and Vulvar Mesenchymal Tumours. Current Diagnostic Pathology, 9, 26-38.

[8]   Iosif, C.S., Batra, S., Ek, A. and Astedt, B. (1981) Estrogen Receptors in the Human Female Lower Urinary Tract. American Journal of Obstetrics & Gynecology, 141, 817-820.

[9]   Batra, S.C. and Iosif, C.S. (1987) Progesterone Receptors in the Female Lower Urinary Tract. The Journal of Urology, 138, 1301-1304.

[10]   Orosz, Z., Lehoczky, O., Szoke, J. and Pulay, T. (2005) Recurrent Giant Fibroepithelial Stromal Polyp of the Vulva Associated with Congenital Lymphedema. Gynecologic Oncology, 98, 168-171.