Hidradenoma papilliferum of the vulva presenting as a hydrocele of the Nuck’s channel

Abstract

Background: Hidradenoma papilliferum is an uncommon benign neoplasm arising from apocrine glands which very rarely occurs at the skin of anogenital area, predominantly in middle-aged women. It usually presents as a slow-growing, solitary, asymptomatic skin colored or red nodule less than 1cm in diameter, although sometimes it ulcerates and bleeds. The tumor has got a good prognosis and malignant transformation is extremely rare. Case Report: We describe a case of the hidradenoma papilliferum of the vulva in a 41-year-old women, which persisted as an symptomatic nodule on the anterior part of the left major labia during last three months. On examination, a well-circumscribed skin colored nodule of 2 cm size on the anterior part of the left major labia was noted. The nodule was extirpated in toto and the histology revealed a hidradenoma papilliferum. Discussion: Hidradenoma papilliferum is a benign neoplasm, cured only by simple excision. The differential diagnosis includes: Bartholin cyst, abscess, true tumors (lipoma, leiomyoma, sarcoma), or hydrocele of the Nuck’s channel. Although the canal of Nuck normally disappears in the first year of life, it can cause an indirect inguinal hernia or hydrocele of the canal of Nuck, which present as painless edema in the inguinal area or labium. Conclusion: When an adult female presents with a nodular lesion in the anogenital area, hidradenoma papilliferum should be kept in mind along with other conditions such as sexually transmitted diseases and other benign and malignant tumors.