CLINICAL NOTE
Vaginal Polyp A
in a Newborn—A Case
Report
and Review of the Literature
in the newborn
or in the infant girl is extremely rare. It is a benign tumor of the vagina. rise to the clinical impression of sarcoma botryoides, but it also may have bizarre histologic features suggesting malignancy, compounding the clinical confusion.’i A 2-day-old girl, the second child of healthy unrelated parents 21 and 24 years old, was admitted to our hospital with the complaint of vaginal mass and icterus. She was born at 42 weeks gestation through a normal spontaneous vaginal delivery. The pregnancy had been uncomplicated, and there was no exposure to drugs, infections, alcohol, and other known toxins during pregnancy. Physical examination revealed a solid polypoid mass originating from the hymen which was 8 X 10 mm in diameter in addition to the finding of hyperbilirubinemia (Fig. 1). The general clinical examination did not reveal any other pathologic findings. Laboratory examinations were normal, except for bilirubin, which was 14.8 total 1, 4 direct mg/dl. Thoracic and plane abdominal radiography and ultrasonography of the brain, abdomen, and pelvic area were normal. The mass was excised totally. Pathologic examination of the specimen revealed a vaginal polyp (Fig. 2). The clinical course of the hospitalization was uneventful and she was discharged 6 days after her admission. Vaginal polyps in the newborn are extremely rare. Norris and Taylor2 reported two cases and Takohashi3 reported one. We could not find any additional cases in the literature.
vaginal polyp
Nonetheless, it may
not
only give
FIG. 1. Photograph of the 2-day-old newborn with vaginal polyp. Polyp is pedunculated and originating from the hymenal
ring.
FIG. 2. A panoramic view of the vaginal polyp. Fibrovascular stroma and acanthotic multilayered squamous epithelia are the main components (hematoxylin and eosin, original magnification X6).
Grapelike or polypoid masses in the vagina lead to the clinical impression of botryoid embryonal rhabdomyoespecially when found in infants or young adults. Little attention has been directed to a similar appearing benign vaginal polyp.’ Age of the patient is not a differential criterion between sarcoma botryoides and vaginal polyp; both can be seen in the newborn infant. Pathologic examination of the mass is adequate to make a differential diagnosis of these tumors. The histologic diagnosis of sarcoma botryoides is based upon the following features: primitive neoplastic mesenchymal cells, a subepithelial cambium cell layer, invasion of the epithelium by neoplastic cells, cells containing cytoplasmic cross striations, and a history of rapid growth. 1,2 None of these histologic features was seen in our case.-MEHMET PUL, MD, Department of Pediatric Surgery, Karadeniz Technical University, Medical Facility, Farabi ~-Iospital, 61080 Trabzon, Turkey, NURAN YILMAZ, MD, NACI GIRSES, sarcoma,
MD
AND
YAVUZ OZORAN, MD.
(1) Mettinen M, Wahlstr6m T, Vesterinen E, et al. Vaginal polyps with pseudosarcomatous features-clinicopathologic study of seven cases. Cancer 51:114$-51. (2) Norris HI, Taylor HB. Polyps of the vagina. Cancer 1986;19:227-32. (3) Takahashi G. Vaginal polyp in an infant girl. Hinyokika Kiyo 1987;3318:1300-2. References:
346
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Vaginal Polyp A
in a Newborn—A Case
Report
and Review of the Literature
in the newborn
or in the infant girl is extremely rare. It is a benign tumor of the vagina. rise to the clinical impression of sarcoma botryoides, but it also may have bizarre histologic features suggesting malignancy, compounding the clinical confusion.’i A 2-day-old girl, the second child of healthy unrelated parents 21 and 24 years old, was admitted to our hospital with the complaint of vaginal mass and icterus. She was born at 42 weeks gestation through a normal spontaneous vaginal delivery. The pregnancy had been uncomplicated, and there was no exposure to drugs, infections, alcohol, and other known toxins during pregnancy. Physical examination revealed a solid polypoid mass originating from the hymen which was 8 X 10 mm in diameter in addition to the finding of hyperbilirubinemia (Fig. 1). The general clinical examination did not reveal any other pathologic findings. Laboratory examinations were normal, except for bilirubin, which was 14.8 total 1, 4 direct mg/dl. Thoracic and plane abdominal radiography and ultrasonography of the brain, abdomen, and pelvic area were normal. The mass was excised totally. Pathologic examination of the specimen revealed a vaginal polyp (Fig. 2). The clinical course of the hospitalization was uneventful and she was discharged 6 days after her admission. Vaginal polyps in the newborn are extremely rare. Norris and Taylor2 reported two cases and Takohashi3 reported one. We could not find any additional cases in the literature.
vaginal polyp
Nonetheless, it may
not
only give
FIG. 1. Photograph of the 2-day-old newborn with vaginal polyp. Polyp is pedunculated and originating from the hymenal
ring.
FIG. 2. A panoramic view of the vaginal polyp. Fibrovascular stroma and acanthotic multilayered squamous epithelia are the main components (hematoxylin and eosin, original magnification X6).
Grapelike or polypoid masses in the vagina lead to the clinical impression of botryoid embryonal rhabdomyoespecially when found in infants or young adults. Little attention has been directed to a similar appearing benign vaginal polyp.’ Age of the patient is not a differential criterion between sarcoma botryoides and vaginal polyp; both can be seen in the newborn infant. Pathologic examination of the mass is adequate to make a differential diagnosis of these tumors. The histologic diagnosis of sarcoma botryoides is based upon the following features: primitive neoplastic mesenchymal cells, a subepithelial cambium cell layer, invasion of the epithelium by neoplastic cells, cells containing cytoplasmic cross striations, and a history of rapid growth. 1,2 None of these histologic features was seen in our case.-MEHMET PUL, MD, Department of Pediatric Surgery, Karadeniz Technical University, Medical Facility, Farabi ~-Iospital, 61080 Trabzon, Turkey, NURAN YILMAZ, MD, NACI GIRSES, sarcoma,
MD
AND
YAVUZ OZORAN, MD.
(1) Mettinen M, Wahlstr6m T, Vesterinen E, et al. Vaginal polyps with pseudosarcomatous features-clinicopathologic study of seven cases. Cancer 51:114$-51. (2) Norris HI, Taylor HB. Polyps of the vagina. Cancer 1986;19:227-32. (3) Takahashi G. Vaginal polyp in an infant girl. Hinyokika Kiyo 1987;3318:1300-2. References:
346
Downloaded from cpj.sagepub.com at NANYANG TECH UNIV LIBRARY on May 26, 2015
