502 Obstetrics and Gynecology Board Review •••
❍ What is the most common cause of a Bartholin cyst abscess?
Gonorrhea.
❍ What happens to a large number of cases of lichen sclerosus et atrophicus of the vulva in children when
they reach puberty?
A large percentage of these cases involute or regress spontaneously.
❍ What is the most common age of development of lichen sclerosus et atrophicus?
Postmenopausal women, but it can occur at any age and sex.
❍ What are some ectopic tissues that can occur in the labia?
Breast (along the milk line), salivary gland tissue, and mesothelial cysts. In addition, various rests of embryonic
tissues can occur.
❍ What benign lesion can occur in the vulva and is thought to arise from sweat glands?
Papillary hidradenoma (hidradenoma papilliferum).
❍ Describe the typical patient who develops papillary hidradenoma.
This tumor is rare overall; however, it tends to occur in Caucasian females after puberty. This correlates with the
development of the apocrine sweat glands that are the origin of this tumor.
❍ What types of human papillomavirus (HPV) are typically recovered from condylomatous lesions of the
vulva?
As in other locations with HPV lesions, the benign appearing condyloma acuminata tend to have HPV types 6 and
11, while squamous cell carcinoma in situ and invasive squamous cell carcinoma of the vulva tend to be associated
with types 16, 18, and 31.
❍ What tumor that most commonly occurs in the soft tissue of the vulva of young to middle-aged women, is
characteristically well circumscribed, shows positive immunoreactivity for vimentin and desmin, and has
been reported to occur in males?
Angiomyofibroblastoma.
❍ What tumor typically occurs in women <40 and involves the genitalia, is poorly circumscribed, and has
distinct myxoid and vascular areas histologically?
Aggressive angiomyxoma.
❍ What is the most common type of HPV found in vulvar intraepithelial neoplasia (VIN) and invasive
squamous cell carcinoma of the vulva?
HPV type 16.
❍ What is the most common malignant tumor of the vulva?
Squamous cell carcinoma.