Track: Case Reports

Topic: Other

Abstract:

Mammary glands in the vulva are recognized now as a normal component of the anogenital region. Lesions originating from these anogenital mammary-like glands (AGMLG) exhibit wide variability, encompassing hidradenoma papilliform, fibroadenoma, hidradenocarcinoma, phyllodes tumors, and others. Furthermore, epithelial, or stromal changes can manifest, some resembling those found in benign breast diseases like sclerosing adenosis, columnar cell lesions, ductal lesions, and various metaplastic changes affecting epithelium and myoepithelium. We present a case of a 39-year-old female presenting with an eroded red exophytic plaque on the labia minora, suspected clinically to be a pyogenic granuloma. Microscopic examination revealed a lobular proliferation of variably dilated and branched tubules and ductules surrounded by loose fibrous stroma. The glands were lined by ovoid to cuboidal basal cells and luminal columnar cells with apocrine snouts. Proliferative fibrocystic changes, including usual ductal hyperplasia, microcysts, and fibrosis, with fibroadenomatoid changes were noted. No significant mitotic activity, infiltrative architecture, or cytologic abnormalities were observed.Immunohistochemical stain for CD10 highlighted an intact myoepithelial layer surrounding the ductal epithelium, which expressed CK7, diffuse estrogen receptor, and progesterone receptors. However, the lesional cells were negative for p16, CDX2, and CK20. The histomorphologic and immunohistochemical features corresponded to non-neoplastic vulvar mammary-like gland tissue with proliferative fibrocystic and fibroadenomatoid changes.Lesions of the anogenital mammary-like gland tissue, both benign and malignant, are relatively rare and are often categorized by dermatopathologists as cutaneous adnexal neoplasms. However, these lesions also warrant evaluation by breast pathologists to facilitate recognition and precise classification of mammary-associated lesions and prevent misdiagnosis

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Jesse McKenney, MD