Extensive Squamous Metaplasia in Hidradenoma Papilliferum of Vulva: Illusion of Squamous Cell Carcinoma

  • Yagnesh V. PatelEmail author
  • Meeta H. Mankad
  • Chetana D. Parekh
  • Amrita Makhija
Case Report



Hidradenoma papilliferum is a rare, slow-growing, benign, cystic, papillary tumour occurring in middle-aged females, in the anogenital region commonly. It involves the anogenital mammary-like glands and is usually asymptomatic. Simple excision is curative.

Case Report

We present a case of hidradenoma papilliferum of long-standing duration with extensive squamous metaplasia. A post-menopausal lady presented with an exophytic growth on the left labia majora and part of mons pubis. It was initially misdiagnosed on the basis of vulvar biopsy and managed as squamous cell carcinoma of the vulva. The final histopathology revealed an epithelial tumour involving the vulva with extensive squamous metaplasia. The tumour involved mainly the dermis and the subcutaneous tissue. This is the first case in the literature where the diagnosis of hidradenoma papilliferum was confused with squamous cell carcinoma of the vulva due to its clinical presentation and extensive squamous metaplasia.


Diagnosis of hidradenoma papilliferum should be kept in mind if a woman presents with vulval papillary or nodular lesions. An expert clinical and histopathological review should be done to avoid misdiagnosis.


Squamous cell carcinoma Hidradenoma papilliferum Vulvar carcinoma Squamous metaplasia 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Konstantinova AM, Michal M, Kacerovska D, Spagnolo DV, Stewart CJ, Kutzner H, Zelger B, Plaza JA, Denisjuk N, Hejda V, Shelekhova K. Hidradenoma papilliferum: a clinicopathologic study of 264 tumors from 261 patients, with emphasis on mammary-type alterations. Am J Dermatopathol. 2016;38(8):598–607.CrossRefGoogle Scholar
  2. 2.
    Scurry J, van der Putte SC, Pyman J, Chetty N, Szabo R. Mammary-like gland adenoma of the vulva: review of 46 cases. Pathology. 2009;41(4):372–8.CrossRefGoogle Scholar
  3. 3.
    Baker GM, Selim MA, Hoang MP. Vulvar adnexal lesions: a 32-year, single-institution review from Massachusetts General Hospital. Arch Pathol Lab Med. 2013;137(9):1237–46.CrossRefGoogle Scholar
  4. 4.
    Duhan N, Kalra R, Singh S, Rajotia N. Hidradenoma papilliferum of the vulva: case report and review of literature. Arch Gynecol Obstet. 2011;284(4):1015–7.CrossRefGoogle Scholar
  5. 5.
    Docimo S, Shon W, Elkowitz DE. Bartholin’s abscess arising within hidradenoma papilliferum of the vulva: a case report. Cases J. 2008;1(1):282.CrossRefGoogle Scholar
  6. 6.
    Barre C, Lorenzato M, Bourdat B, Quereux C, Durlach A. Vulvar invasive squamous cell carcinoma and hidradenoma papilliferum. Case report. Gynecol Obstet Fertil. 2007;35(9):776–9.CrossRefGoogle Scholar
  7. 7.
    Kazakov DV, Mikyskova I, Kutzner H, Simpson RH, Hes O, Mukensnabl P, Bouda J, Zamecnik M, Kinkor Z, Michal M. Hidradenoma papilliferum with oxyphilic metaplasia: a clinicopathological study of 18 cases, including detection of human papillomavirus. Am J Dermatopathol. 2005;27(2):102–10.CrossRefGoogle Scholar

Copyright information

© Association of Gynecologic Oncologists of India 2019

Authors and Affiliations

  • Yagnesh V. Patel
    • 1
    Email author
  • Meeta H. Mankad
    • 1
  • Chetana D. Parekh
    • 1
  • Amrita Makhija
    • 1
  1. 1.Department of Gynecologic OncologyGujarat Cancer and Research InstituteAhmedabadIndia

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