Table 5 Cyst of the Canal of Nuck
Cyst of the canal of Nuck
Inguinal or labial mass. Hernia may become incarcerated
Cystic mass of labia majora
Lipoma, leiomyoma, Sarcoma (11), indirect hernia, Bartholin's cyst, or abscess, inguinal adenopathy
(Fig. 8A-C) (17). The diagnosis is straightforward in most cases, both clinically and pathologically. The usual fibroepithelial polyp is an epithelium-covered stromal polyp with a stroma that may be loose or more collagenous, and contains bland spindle cells. A fibrovascular core is often present. Histologically worrisome features may be seen, particularly in the pregnant patient, with hypercellularity, nuclear pleo-morphism, and increased mitotic activity in the stroma, prompting the use of the term "pseudosarcoma botryoides.'' Characteristic stellate and multinucleated cells aid in the distinction from a true sarcoma. These pseudosarcomas may recur, particularly if not totally excised, but have no destructive or metastatic potential (18,19). The stromal cells often exhibit positivity for vimentin, desmin, and estrogen (ER) progesterone (PR) receptors. They may occasionally recur in subsequent pregnancies, but are not infiltrative, and can be re-excised (Table 8) (20).
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