[466] Vulvar Adnexal Neoplasms: A Thirty-Two Year Single-Institution Review

Gabrielle M Baker, Mai P Hoang. Massachusetts General Hospital, Boston, MA

Background: The incidence of various adnexal neoplasms occurring in the vulvar region has not been reported.
Design: A retrospective review of the case files at our institution was performed (1978-2010).
Results: A total of 194 vulvar adnexal neoplasms were identified. The majority of these neoplasms were benign (136/194, 70.1%) with hidradenoma papilliferum being the most common followed by syringoma and various types of cysts. Malignant adnexal neoplasms comprised the remaining 29.9% (58/194) with Extramammary Paget Disease being the most common.

Benign Vulvar Adnexal Neoplasms (n=136; Total n = 194)

Type	Number of Cases (% of Benign, % of Total)	Age Range, years (Median, years)
Hidradenoma Papilliferum	80 (58.8%, 41.2%)	24-80 (50)
Syringoma	29 (21.3%, 14.9%)	12-74 (51)
Cysts*	13 (9.5%, 6.7%)	20-73 (51)
Poroma	4 (2.9%, 2.1%)	27-77 (56)
Dilated Pore of Winer	2 (1.5%, 1%)	25-56 (40.5)
Spiradenoma	2 (1.5%, 1%)	60-71 (65.5)
Apocrine Tubular Adenoma	1 (0.7%, 0.5%)	60
Cylindroma	1 (0.7%, 0.5%)	71
Hidradenoma	1 (0.7%, 0.5%)	73
Sebaceoma	1 (0.7%, 0.5%)	46
Sebaceous Trichofolliculoma	1 (0.7%, 0.5%)	26
Trichoepithelioma	1 (0.7%, 0.5%)	64

* Cyst subtypes: Epidermoid cyst (n=6), Pilar cyst (n=2), Pilomatricoma (n=2), Trichilemmal cyst (n=2), Hidrocystoma (n=1).

Malignant Vulvar Adnexal Neoplasms (n=58; Total n = 194).

Type	Number of Cases (% of Malignant, % of Total)	Age Range, years (Median, years)
Extramammary Paget Disease (EPD)*	49 (84.5%, 25%)	53-92 (75)
Basal Cell Carcinoma	2 (3.4%, 1%)	80-82 (81)
Sebaceous Carcinoma	2 (3.4%, 1%)	71
Adenocarcinoma, Mucinous	1 (1.7%, 0.5%)	71
Adenocarcinoma, NOS	1 (1.7%, 0.5%)	46
Adenoid Cystic Carcinoma	1 (1.7%, 0.5%)	36
Eccrine Carcinoma	1 (1.7%, 0.5%)	70
Spiradenocarcinoma	1 (1.7%, 0.5%)	50

*EPD, subset with invasive component: 14/49, 24% of malignant neoplasms, 7.2% of total.


Conclusions: This review provides insight into the diversity of adnexal neoplasms occurring in the vulva and their relative frequency. Although several entities predominate, the spectrum of neoplasms observed in this review reflects that which is seen systemically and correlates with the relative abundance of apocrine, apoeccrine and anogenital mammary-like glands present in the skin and modified mucosal surfaces of the vulva.
Category: Dermatopathology

Tuesday, March 20, 2012 9:30 AM

Poster Session III # 108, Tuesday Morning