Benign and Malignant Conditions of the Vagina and Vulva (Moulton)

Question 1

1) What structural and benign neoplastic condition of the vulva causes severe pruritic raised yellow retention cyst in the axilla, labia majora and minora?

It results from __2__ plugged inflammation of __3__ glands.

Answer 1

1) Fox-Fordyce disease
2) Keratin
3) Apocrine

Question 2

__1__ are the most common type of genital cyst.

They develop when the __2__ become obstructed.

Answer 2

1) Epidermal inclusion cysts

2) Hair follicles

Question 3

What can enlarge and become painful in pregnancy and have characteristic blue color?

Answer 3

Vulvar varicosities

Question 4

__1__ appear as a small fleshy red outgrowth at the distal edge of the urethra.

In children they are caused by the spontaneous prolapse of the __2__.

In post menopausal women it is secondary to contraction of the hypoestrogenic __3__ epithelium resulting in everting of the __4__ epithelium.

Answer 4

1) Urethral caruncles
2) Urethral epithelium
3) Vaginal
4) Urethral

Question 5

__1__ is a rare condition in which one or more of the minor vestibular glands becomes infected resulting in 1 - 4mm erythematous dots that are extremely tender.

They are characterized by severe __2__ and occasionally vulvar pain.

It may be treated with topical __3__ and __3__ or surgical therapy may be required.

Answer 5

1) Vulvar vesitbulitis (Vestibular adenitis)
2) Dyspareunia
3) Estrogens/hydrocortisone

Question 6

What are small, smooth, nodular masses usually on inner surface of labia minora and majora due to inflammatory blockage of its ducts?

How can the material that they contain be described?

Answer 6

1) Sebaceous cyst

2) Cheesy sebaceous material

Question 7

What are the most common benign solid tumors of the vulva? They are slow growing, most range from 1-10 cm.

Answer 7

Fibromas

Question 8

What are slow growing tumors composed of adipose cells?

Answer 8

Lipoma

Question 9

What are rare lesions arising from sweat gland of the vulva?

Answer 9

Hidradenoma

Question 10

Syringoma is a(n) ____ gland tumor.

Answer 10

Eccrine

Question 11

What tumor can occur due to Von Recklinghausen’s disease?

Answer 11

Neurofibroma

Question 12

What tumor appear as multiple 2-3 mm red lesions usually in fourth & fifth decade?

Answer 12

Angioma

Question 13

What are loculated collections of blood that collect following trauma such as bike injuries (straddle injury), birth trauma or sexual assault?

Answer 13

Vulvar hematomas

Question 14

An exam that reveals atrophy of the external genitalia and loss of vaginal rugae is diagnostic of __1__.

It is due to loss of __2__, which may occur due to menopause or surgery.

Treatment involves __3__.

Answer 14

1) Atrophic vaginitis
2) Estrogen
3) Topical estrogen (may use oral to prevent recurrence)

Question 15

Local thickening of epithelium that reveals white, leathery, raised surface is diagnostic of?

What does it results from?

Answer 15

1) Lichen simplex chronicus (Squamous cell hyperplasia)

2) Chronic itching of the area

Question 16

What does biopsy of Lichen simplex chronicus reveal?

Answer 16

1) Elongated rete ridges

2) Hyperkeratosis of keratin layer

Question 17

__1__ reveals thin, white, inelastic skin with a crinkled tissue paper appearance that causes pruritus, dyspareunia, and burning pain.

It is frequently found on the vulva of __2__women.

Answer 17

1) Lichen sclerosis

2) Menopausal

Question 18

4% of treated women & 10% of untreated women with lichen sclerosis can develop ____ of the vulva.

Answer 18

Squamous cells cancer

Question 19

What does biopsy of Lichen sclerosis reveal?

Answer 19

1) Thin epithelium
2) Loss of rete ridges
3) Inflammatory cells lining basement membrane

Question 20

Lichen simplex chronicus presents with marked hyperkeratosis and parakeratosis with a prominent ____ layer.

Answer 20

Granular

Question 21

The most striking feature of lichen sclerosis is the presence of a ____ zone in the superficial dermis. This is the result of edema and degeneration of the collagen and elastic fibers of the dermis.

Answer 21

Hyaline

Question 22

Purplish, polygonal papules that may appear in an erosive form causing vulvar burning and severe dyspareunia is diagnostic of?

Answer 22

Lichen planus

Question 23

Autoimmune blistering disease involving the vulvovaginal conjunctival areas is characteristic of?

Answer 23

Pemphigus

Question 24

What syndrome classically involves ulcerations in the genital, oral areas with uveitis?

Answer 24

Bechet’s syndrome

Question 25

What is primarily a GI disorder but vulvar ulcerations can occur due to fistulations?

Answer 25

Chron’s

Question 26

What ulcers can develop when chronic pressure is applied or secondary to tissue being moist secondary to urinary incontinence?

Answer 26

Decubitus ulcers