Vulvar apocrine tumor

Introduction to vulvar apocrine adenoma Vulvar sweat adenomas are tumors formed by epithelial hyperplasia of the sweat glands, generally benign, and very few are malignant. Since apocrine glands function only after sexual development, this sweat adenoma occurs after adulthood. The growth site is mainly in the labia majora. basic knowledge The proportion of the disease: the incidence rate is about 0.001% -0.002% Susceptible people: women Mode of infection: non-infectious complication:

Causes of vulvar apocytosis

(1) Causes of the disease

It is generally believed that sweat adenomas occur in the apocrine glands, but it is unknown whether they originate from the apocrine gland or the glandular gland structure. The reason for supporting it to occur in the apocrine gland is that the apical cells do not secrete until puberty until puberty. There is a secretory function, and sweat adenomas are not encountered before puberty, but there are still some points that cannot be explained. For example, axillary follicles, areola, haze, etc. are extremely rich in apical cells, and there are also a few tops in small sweat glands. Plasma cells, but sweat adenomas rarely occur, and the vulva and perianal are more likely to occur. Moreover, the black sweat cap glands are three times as large as whites, and the incidence should be increased accordingly, but the incidence of blacks is reported in the literature. low.

Regarding the source of the adenoma of the labia minora, there is also controversy. If the sweat adenoma occurs in the apical cell origin, the hair follicle should be found nearby, but it is often difficult to find in the labia minora. Woodworth studied these glands and found that it is more than normal. The small sweat glands of the skin are larger, smaller than the parietal glands, and stained with Prussian blue to identify small sweat gland cells or apical cells. Because the apical cells contain iron components, the small sweat gland cells are absent. The sweat gland epithelial cells in the labia are free of iron, so some people think that the source of sweat adenoma in the labia minora is neither a small sweat gland nor an apocrine gland, but another type of gland between the two. Unique to the labia minora.

(two) pathogenesis

The tumor is usually a single round solid nodule, soft, surface covered with normal skin, even ruptured, eversion, forming a reddish-brown papilloma-like mass, and easy to hemorrhage, quite like cancerous or inflammatory granulation, tumor Located in the shallow layer of the dermis, close to the epidermis, the diameter of 0.1 ~ 1cm, an average of 0.8cm, the boundary is clear.

The microscopic morphology is similar to the papilloma of the large breast duct. There are many tubular or capsular cavities in the tumor. The cavities have an anastomosis in the cavity. There are two layers of cells on the surface, that is, the wall and the nipple are often lined with a single A layer of apocrine glandular high columnar cells with large nuclei, lightly stained, cytoplasmic acidophilus, often secreted by the apical pulp; a peripherally arranged cubic squamous epithelial cell.

Vulvar apocrine adenoma prevention

1, regular physical examination: to achieve early detection, early diagnosis, early treatment.

2, good follow-up: to prevent the disease from getting worse.

3, pay attention to personal hygiene, especially the health of the genitals during menstruation and puerperium.

4, enhance physical fitness, improve their own immunity: pay attention to work and rest, more to participate in physical exercise, eat more fresh fruits and vegetables rich in vitamins.

Vulvar apocrine adenoma complications Complication

Superficial ulcers and concurrent infections occur.

Vulvar apocrine adenoma symptoms Common symptoms Cysts urinating when the vulva is burning... Skin necrosis smelly nodules

The growth site often wrinkles between the labia majora or the labia majora, the perianal and perineum, because the labia minora lacks sweat glands, so it rarely occurs, and there is no clinical manifestation. It only feels an induration. In a few cases, it has pain, itching, and burning. Such symptoms, such as secondary infection after ulceration, local pain, discharge, bleeding, odor, fever and other symptoms, vulvar apocrine abdomen occasionally found that the vulva has a round slightly higher than the skin The mass of the lesion is usually single and the boundary is clear. The duration of the sweat adenoma varies. Some sweat adenomas can last for more than 10 years without change, but in pregnancy, they can increase rapidly in a short period of time. Generally, the diameter of sweat adenoma is about 1cm. Those with a diameter > 2 cm are a minority.

There are three types of clinical manifestations of sweat adenoma: 1 cyst type, quite like sebaceous cyst; 2 parenchyma, which is a subcutaneous induration; 3 ulceration type, after surface skin necrosis, sweat gland tissue is red granulation or papillary Broken, at this time the appearance is very similar to cancer.

Examination of vulvar apocrine adenoma

Tumor marker examination, secretion examination.

Histopathological examination.

Diagnosis and differentiation of vulvar apocytosis

diagnosis

Diagnosis often needs to be made according to pathological examination, such as by naked eye observation, it is not easy to identify, sweat adenoma cyst type is often misdiagnosed as sebaceous cyst, the parenchymal type is often misdiagnosed as female vaginal cancer or vestibular adenoma, ulceration Types are more likely to be misdiagnosed, often misdiagnosed as sarcoma, papillary adenocarcinoma, by the naked eye, it is not easy to identify, must be confirmed after biopsy, according to Woodworth report, even if the pathological diagnosis, the initial diagnosis rate is 57%, before the 1950s, such pathology was often misdiagnosed as adenocarcinoma. In recent years, there has been a clear understanding of this tumor, and the rate of misdiagnosis has been greatly reduced.

Differential diagnosis

1. Skin attachment Adenocarcinoma has no cystic or papillary structure, lacks myoepithelial layer, and cells are more atypia.

2. Metastatic cancer lacks two layers of cells, invasive growth, and primary lesions.

3. The ectopic breast tissue has a lobular structure, and the glandular cavity has obvious secretions, often with a catheter.

4. Endometriosis and so on.

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