Abstract

We present a 35-year-old woman with a several year history of a painful lesion on the labium majora. The lesion had been previously excised with an unknown prior diagnosis. Clinical examination was significant for a skin-colored, soft, approximately 1 cm exophytic nodule of the left mid labium majora. A shave biopsy was performed. Histopathological examination revealed a cyst lined by a single-layered mucinous columnar epithelium. The lining was immunoreactive for CAM 5.2 and CK7 and non-reactive for CEA. Colloidal iron and mucicarmine highlighted mucin within the cyst lining and cavity. A Ki67 immunostain demonstrated a low proliferative index of the epithelium (<5%). Based on these findings, a diagnosis of benign cutaneous endocervicosis was made. Endocervicosis is a type of müllerianosis, a group of benign conditions characterized by ectopic embryonic müllerian epithelium. Endocervicosis typically presents as a cystic lesion with endocervical-type lining which consists of a single layer of unevenly arranged non-ciliated columnar cells with mucin. It most commonly affects women between the ages of 29 and 45 years. While endocervicosis most frequently affects the bladder, involvement of the vaginal mucosa, small intestine, axillary lymph nodes, rectum and small intestine have been reported. Here, we report a rare case of endocervicosis with cutaneous involvement. Because malignant transformation can rarely occur, careful examination is warranted.

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