Hidradenoma Papilliferum of Vulva Simulating Vulval Carcinoma: A Case Report

Purpose Vulval Hidradenoma papilliferum is a rare benign tumor originating from apocrine sweat glands. They present as a solid solitary nodule of 1-2 cm on the inner margin of labia majora. Since they are not commonly encountered, their diagnosis is usually difficult and puzzles with other conditions such as benign and malignant lesions of the skin, vulva, and perineum. The present case report highlights one such case of vulval Hidradenoma papilliferum in a postmenopausal woman diagnosed after a histopathological examination of an excised lesion.Case Presentation A 55-year-old P2L2 postmenopausal woman presented to the Gynecology outpatient department complaining of itching over the vulval region for 3-4 months. There was no associated bleeding or discharge per vaginum. On local examination, a single nodular, hypopigmented, non-tender, ulcerative lesion was seen over the right labia majora of size 1x2 cm. It was solid in consistency. The lesion was excised and sent for histopathological examination, which revealed a well-circumscribed subepithelial tumor composed of delicate, complex branching papillae and glandular elements lined by columnar epithelial secretory cells and myoepithelial cells suggestive of hidradenoma papilliferum.Major Findings The diagnosis of hidradenoma papilliferum is usually made on surgical excision and histopathological evaluation of lesions. Hidradenoma papilliferum is difficult to diagnose clinically as it mimics other benign and malignant gynecological and cutaneous diseases.Conclusion Hence, hidradenoma papilliferum should be kept as a differential in diagnosing women with solitary asymptomatic nodules in the anogenital region.