2024 年第 4 期 第 19 卷

外阴良性肿瘤的病理特征及临床分析

Pathological characteristics and clinical analysis of benign vulvar neoplasm

作者：李琳郭银树钱景锋郑兴

英文作者：Li Lin Guo Yinshu Qian Jingfeng Zheng Xing

单位：首都医科大学附属北京妇产医院北京妇幼保健院妇科微创中心，北京100006

英文单位：Gynecological Minimal Invasive Center Beijing Obstetrics and Gynecology Hospital Capital Medical University Beijing Maternal and Child Health Care Hospital Beijing 100006 China

关键词：外阴良性肿瘤；病理特征；临床诊疗；预后分析

英文关键词：Benignvulvarneoplasm;Pathologicalfeatures;Clinicaldiagnosisandtreatment;Prognosticanalysis

• 摘要：

• 目的 探讨外阴良性肿瘤的临床特点、病理特征及治疗预后，总结相关的临床诊治经验。方法 收集2018年1月至2022年12月因外阴肿物收入首都医科大学附属北京妇产医院妇科微创中心住院治疗的24例经病理检查证实为外阴良性肿瘤患者的临床及病理资料进行回顾性分析。探讨发病年龄、临床症状体征、肿物性状特点、病理类型、治疗及转归情况。结果 24例患者中仅2例（8.3%）为多发病灶，其余患者均为单发。发病年龄为14～78岁，中位发病年龄为38岁，围绝经期患者2例（8.3%）。所有患者表现为自触和/或在妇科检查时发现外阴肿物，有2例伴异味及破溃；病程为2周～70年；3例表现为外阴囊性肿物，21例表现为外阴实性肿物（包括8例外阴皮赘），包块大小为0.5～8 cm。术后病理诊断为外阴软纤维瘤者8例，平滑肌瘤4例，外阴皮内痣、纤维瘤、乳头状汗腺腺瘤、血管肌纤维母细胞瘤各2例，多发鳞状细胞乳头状瘤、脂肪瘤、细胞性血管纤维瘤、孤立性纤维性肿瘤各1例。除1例外阴多发鳞状细胞乳头状瘤患者行单纯外阴切除术，其余患者均采用局部病灶切除术。术后随访3个月～5年，均未见复发。结论 外阴良性肿瘤多为单发，实性肿物多见，常无明显自觉症状，病理类型呈多样性，预后较好，建议尽早手术切除，术后加强随访。

• Objective To investigate the clinical characteristics, pathological features, treatment and prognosis of benign vulvar neoplasm, and to summarize the relevant clinical diagnosis and treatment experience. Methods The clinical and pathological data of 24 patients with benign vulvar neoplasm confirmed by pathological examination in the Gynecological Minimal Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2018 to December 2022 were collected and retrospectively analyzed. The age of onset, clinical symptoms and signs, characteristics of the tumor, pathological types, treatment and outcome were analyzed. Results Of the 24 patients, only 2 patients (8.3%) had multiple lesions, and the remaining patients had a single lesion. The age of onset was 14 to 78 years old, median age of onset was 38.3 years old. There were 2 cases(8.3%) of perimenopausal patients. All patients presented with palpable and/or detected external genital masses during gynecological examinations, with 2 cases accompanied by odor and ulceration. The course of the disease was 2 weeks to 70 years. Three cases were external scrotal masses, and 21 cases presented as solid external genital masses (including 8 cases of external genital skin growths), with a mass size of 0.5-8 cm. Among the postoperative pathologies, 8 cases were vulvar soft fibroids, 4 cases were leiomyomas, 2 cases were vulvar intradermal nevi, fibromas, papillary sweat gland adenomas, and vascular myofibroblastoma respectively, 1 case was multiple squamous cell papilloma, lipoma, cellular vascular fibroma, and isolated fibrous tumor respectively. Except for 1 case with multiple squamous cell papilloma of the external genitalia who underwent simple vulvar resection, all other patients underwent local lesion resection. Follow up for 3 months to 5 years after surgery showed no recurrence. Conclusion Benign vulvar neoplasm is mostly single solid masses, often without obvious subjective symptoms. The pathological types are diverse, and the prognosis is good. Early surgical resection and postoperative follow-up are recommended.