A Mass at Labia Majora in a Non-Cyclist Mimicking Perineal Nodular Induration

非自行車手大陰唇腫塊類似會陰部結節性腫塊

Hsin-Miao Sun(孫欣妙) ； I-Chen Chen(陳伊呈) ； Jing-Tong Fu(傅景佟) ； Yong-Chen Hsu(許永楨) ； Chen-Yu Wu(吳鎮宇)

《臺灣整形外科醫學會雜誌》 33卷3期 (2024/09) Pp. 342-348

摘要

Background: As bicycle riding becomes more popular, perineal nodular induration (PNI) is getting noticed in male cyclists. PNI is a rare benign disease over the perineal area, occurring as an inflammatory response to exogenous or endogenous lipids, and is related to repeated microtrauma. PNI is mostly diagnosed in male cyclists over 40-year-old with repeated friction. Its pathological characteristics are fat vacuoles with foreign body type of giant cells and scattered lymphocytes. Aim and Objectives: We present this rare case of PNI-like lesion in a female, and review current literature to give physicians further notice of differential diagnosis and treatment of perineal lesions. Materials and Methods: This is a presentation of a rare female case of PNI-like lesion with lipogranuloma over the labia majora, a patient who was not a cyclist. She received a wide excision before undergoing regular medical follow-ups. Results: PNI was diagnosed pathologically. The patient had no disease recurrence within a year-long follow-up period after surgery. Conclusion: PNI is a benign rare disease over the perineal area, diagnosed not restricted to male cyclists but also in women with minimal cycling history. Further case studies are needed to understand its underlying etiology. Surgical intervention is the gold standard for treatment of PNI.

關鍵字

perineal nodular induration ； lipogranuloma

並列摘要

背景：會陰部結節性腫塊是罕見良性疾病，好發於會陰部、男性、自行車手。可能原因為外部摩擦導致細微的創傷。病理型態會出現脂肪細胞合併對異物反應的巨細胞及淋巴球。目的及目標：大陰唇會陰部結節性腫塊為罕見案例，因此描述案例、並作文獻回顧以提供後續相關案例治療參考，應用在後續病患身上。材料及方法：本篇文章為案例報告，描述一位70歲女性，本身並非為自行車車手，亦無其他相關致病因素，而意外發現會陰部腫塊，經廣泛性切除後，病理診斷為大陰唇會陰部結節性腫塊併油脂肉芽腫塊。後續接受臨床門診追蹤。結果：病人一年後臨床追蹤無局部復發。結論：會陰部結節性腫塊為一發生於會陰部的良性疾病，可發生不僅在男性腳踏車騎士，女性沒有特別因子亦有可能發生。然而需要更多的案例報告來探討不同性別發生此疾病的因素。目前手術切除為治療此疾病的標準治療。