childhood asymmetric labium majus enlargement
"Childhood asymmetric labium majus enlargement" is a distinctive clinicopathologic entity of pre- and early puberty. Recognition of this fairly common lesion is important, since it may clinically, radiographically, and histologically mimic an infiltrative neoplasm. (16006794)
Its occurrence at an age roughly coincident with the time of breast budding, capacity for spontaneous regression, histologic architecture and composition of elements native to the vulva, expression of hormone receptors, and normal karyotype suggest that it is an asymmetric physiologic enlargement in response to hormonal surges of pre- and early puberty. (16006794)
Synopsis
labium majus enlargement
expansion of the labium majus without definable borders
fibro-fatty tissue from 2 to 8 cm in greatest dimension
usual constituents of vulvar soft tissue, with expansion of the fibrous component
sparsely to moderately cellular interconnected bands encircled lobules of fat, blood vessels, and nerves
bands of plump and occasionally stellate or round fibroblasts immersed in an abundant pale myxoid matrix containing thin collagen fibers
fibrous bands merged with thinner denser fibrous septa simlar to those seen in the vulva from age-matched controls.
variably abundant thin parallel elastic fibers
Immunochemistry
Fibroblasts were immunohistochemically positive for estrogen and progesterone receptors.
Electron microscopy
fibroblasts with dilated rough endoplasmic reticulum cisternae and prominent nuclear fibrous laminae;
extracellular matrix contained precollagen, collagen, elastic fibers, and numerous proteoglycan granules.
Cytogenetic analysis
normal karyotype.
References
Vargas SO, Kozakewich HP, Boyd TK, Ecklund K, Fishman SJ, Laufer MR, Perez-Atayde AR. Childhood asymmetric labium majus enlargement: mimicking a neoplasm. Am J Surg Pathol. 2005 Aug;29(8):1007-16. PMID: 16006794