Issues in Dermatopathology
Childhood Asymmetric Labium Majus Enlargement-Mimicking a Neoplasm
Vargas SO, Kozakewich HPW, Boyd TK, Ecklund K Fishman SJ, Laufer MR, Perez-Atayde AR.
Am J Surg Pathol 2005; Aug;29(8):1007-1016
Dermatologists are frequently asked to evaluate genital lesions. This article, presented in the surgical pathology literature, documents a new disease entity that will probably be unfamiliar to most dermatologists and pathologists.
Thirteen of the fourteen patients underwent surgical excision revealing a bland collection of expanded fibrous septa encircling benign fat lobules. A myxoid extracellular matrix was common associated with variable numbers of elastic fibers and fibroblasts.
Clinical follow up for all cases revealed recurrence in 7/14 (50%) cases and the one case that did not undergo surgical excision underwent regression. Immunoperoxidase analysis revealed positivity for estrogen and progesterone receptors. Cytogenetic analysis performed upon 3 of the cases revealed a normal karyotype.
In conclusion, the authors state that CALME is a relatively common and distinctive clinicopathologic entity occurring in the pre- and early pubertal periods. Because these lesions occurred in the milk line, the appearance may coincide with early breast budding. With the presence of hormone receptors, the authors speculate that CALME may represent an asymmetric physiologic enlargement to pre and early pubertal hormonal surges.
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Last Updated September 6, 2005
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