Presentation of a clinical- pathological case of clitomegaly in a 16- year- old adolescent

Abstract

Abstract: 

Summary:

The causes of clitoromegaly can be hormonal and non-hormonal. Among the hormonal ones, endocrinopathies, virilizing tumors and of the adrenal gland are described. Among the non-hormonal benign tumors of the clitoris including fibromas, leiomyomas, angiokeratomas, pseudolymphomas, hemangiomas, glandular cell tumors, hemangiopercytomas and neurofibromas are described. There are cases of both epithelial and mesenchymal malignant tumors. Cysts of the female genital tract are extremely rare, and even more so are those of the clitoris. Some cases of epidermoid cysts of the clitoris, both congenital and acquired, have been reported in the literature. Epidermoid cysts of the clitoris are generally secondary to trauma. The communication of this case tries to highlight the importance of arriving at the etiology of this clinical-pathological entity, which will guide the adequate treatment of this pathology. 16-year-old female patient, reason for consultation with increased size of the clitoris for a year. He denies a history of trauma. Take oral contraceptives. Gynecological examination: menarche at 10 years of age, a significant increase in the clitoris without hypertrophy of the labia minora is found on physical examination. Imaging result corresponding to soft tissue ultrasound: superficial cystic image in projection of the clitoris, measures 34x12x20 mm. The wall is 0.3mm. Surgical treatment and subsequent pathological study of the lesion are indicated for the patient. In the Laboratory, the material is processed with the usual techniques and colored with H&E

Macroscopy: fragmented cystic formation is received (4 fragments) measuring 2.5 cm in diameter grouped together. When cut, the internal surface is smooth, without content. Rough and grayish external surface, elastic consistency. Microscopy: the sections show the cyst wall lined by stratified flat epithelium with mild hyper and parakeratosis, it exhibits signs suggestive of HPV (koilocytosis). The stroma is fibrohyaline with congestive blood vessels. Diagnosis: findings linked to epidermal inclusion cyst, clitoral hypertrophy, and signs suggestive of HPV viral infection. The clinical-pathological case presented highlights the importance of both clinical and imaging aspects as well as the histopathological diagnosis of this entity, which were strongly associated with the etiology of clitoromegaly