Trichofolliculoma-like lesion of the vulva associated with vulvar intraepithelial neoplasia - a case report

Aim Only three cases of vulval trichofolliculoma-like lesion associated with vulvar intraepithelial neoplasia (VIN) have been previously described in the English literature. This is the fourth reported case of trichofolliculoma-like lesion associated with VIN. Case presentation A 39-year-old female presented with a white plaque in the vulva. She had a history of radical hysterectomy for invasive squamous cell carcinoma (SCC) of the cervix 8 years ago and posterior vulvectomy for invasive SCC 2 years ago. The anterior vulval biopsy showed VESf 3 and a dermal trichofolliculoma-like lesion colonised by dysplastic squamous cells. The lesion showed positive immunoperoxidase staining with pl6, as seen in overlying VIN 3. This colonised lesion easily mimics an invasive SCC. Discussion Trichofolliculoma is a rare benign pilar neoplasm of the skin usually found on the scalp, face, or neck. It is an exceedingly rare finding in the genital area. Its histogenesis is unknown. It is not associated with a family history or with other abnormalities. Juxtaposition of trichofolliculoma with VIN 3 in our and previously reported cases is likely to be coincidental. Recognition of benign appendageal tumours in an unusual site allows one to reach the correct diagnosis, and not to misdiagnose them as malignant process.