EP733 Incidental finding of vulvar syringoma during the treatment of vulvar intraepithelial neoplasia – a case report

Introduction/Background Syringoma is a benign eccrine sweat gland tumor which occurs mostly in females at puberty. The sites of predilection are lower eyelids and malar area. Lesions are usually bilateral and symmetrically distributed and they clinically appear as small, multiple, firm, skin-colored, pink to yellowish papules, 2 to 4 mm in diameter. Syringoma of the vulva is a rare condition with only few cases reported in the literature to date. We report a case of 57-year-old woman who presented to gynecology department with vulvar pruritus. Methodology A 57-year-old woman, gravida 3, para 3 was admitted to our department due to abnormal findings of vulvar smear. Patient had been postmenopausal for 6 years. According to the patient, vulvar pruritus had appeared about a year ago. Vulvar smear was taken from indurated area on left labia majora. On left labia majora there were also barely visible confluent nodules on discrete erythematous background. Vulvar smear cytology revealed intermediate vulvar intraepithelial neoplasia and patient underwent wide excision biopsy. Results Histological examination showed findings consistent with vulvar intraepithelial neoplasia grade II but also revealed well-circumscribed structure consisting of small solid and ductal structures with comma-like geometric shapes embedded in a fibrotic stroma in the dermis. The pathological findings confirmed the diagnosis of syringoma. Conclusion Despite being a rare diagnosis, vulvar syringoma should be included in differential diagnosis of vulvar pruritus and multiple vulvar papular lesions. Exclusion of malignancy is mandatory in cases of postmenopausal pruritic lesions. Disclosure The authors declare no conflict of interest.