Fibroepithelial Polyp of the Vagina With Torsion: A Difficult Diagnosis Based on Clinical and Morphological Findings of the Vaginal Lesion

TL;DR

A rare case of a vaginal fibroepithelial polyp with torsion is reported, highlighting the challenges in diagnosis and treatment.

Contribution

This paper presents a rare clinical case of a vaginal fibroepithelial polyp with torsion and discusses its diagnostic difficulties.

Findings

A 63-year-old patient presented with a hemorrhagic polypoid mass from the posterior vaginal wall.

Surgical excision confirmed torsion but limited histological analysis due to tissue necrosis.

The diagnosis of fibroepithelial polyp was made based on clinical and morphological features.

Abstract

Vaginal fibroepithelial polyps are rare benign tumors of the mucosa of the anterior vaginal wall. In extremely rare cases, they may originate from the posterior vaginal wall or be complicated by torsion. Our case concerns a 63-year-old patient who presented to the gynecology outpatient clinic of the General Hospital of Trikala with minor vaginal bleeding. On vaginal examination, a large pedunculated painless hemorrhagic polypoid mass was noticed, originating from the posterior vaginal wall. A torsion of the pedunculated vaginal tumor was suspected, leading to its surgical excision with clear resection margins. Due to extensive tissue necrosis, accurate histological identification of the vaginal neoplasm was not possible. Histological examination excluded vaginal malignancy. Based predominantly on the clinical and morphological features of the vaginal lesion, a diagnosis of vaginal fibroepithelial polyp with torsion was made, acknowledging its limitations. The patient was discharged from the clinic the same afternoon following the surgery. Three months later, no recurrence of the lesion in the vaginal wall was noted. Following the case presentation, this paper provides a brief literature review of this rare entity, focusing on the diagnostic and therapeutic approaches.

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