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Vulvar vestibulitis syndrome is a constellation of symptoms and findings involving and limited to the vulvar vestibule that consists of: (1) severe pain on vestibular touch to attempted vaginal entry, (2) tenderness to pressure localized within the vulvar vestibule, and (3) physical findings confined to vulvar erythema of various degrees. Histopathologic findings are consistent with a chronic, nonspecific inflammatory response that is occasionally associated with metaplasia of the minor vestibular glands. The cause is likely multifactorial, and to date the syndrome has been seen in association with subclinical human papillomavirus, chronic recurrent candidiasis, chronic recurrent bacterial vaginosis, chronic alteration of vaginal pH, and the use of chemical and destructive therapeutic agents. Therapy is directed at elimination of these symptoms. When symptoms are unrelieved, a surgical approach consisting of vestibulectomy with vaginal advancement has a high rate of success.

Four examples of adenocystic (pseudoadenomatous) basal cell carcinoma of vestibular glands of vulva are reported. Three of these arose in the region of the Bartholin gland whereas the exact vulvar location of the fourth was not described but probably was from a major rather than a minor vestibular gland. The tumor is a histologic entiry and consists of small uniform basal cells with pseudoglandular and microcystic formations and usually considerable hyalinized acellular stroma. It pursues a slow insidious course, is prone to local recurrence and perineural spread, and has the ability to metastasize by vascular channels. The neoplasm should not be likened to mixed tumor of the salivary gland or confused with basal cell carcinoma of the skin, or adenocarcinoma of the vestibular glands.