International Journal of STD & AIDS > Volume 19, Number 3 > Pp. 213-214

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Case reports

Be wary, this is not a case of vulval warts!

Medhat S T Basta MRCP DipGUM ^* , Kirti Sharma MD PATHOLOGY  and Mayur Chauhan FRCOG ^*

^* Genitourinary Medicine Department; Histopathology Department, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK

Correspondence to: Dr Medhat S T Basta Email: medhat.basta{at}chs.northy.nhs.uk

We present a 40-year-old woman who presented to the genitourinary medicine department with a two-year history of recurrent non-painful vulval lumps. She was in a stable relation with one male sexual partner over the preceding 20 years and her sexual health screen was negative. Clinical examination of these lumps was suggestive of anogenital warts for which she has been treated on numerous occasions over the last two-year-period with liquid nitrogen cryotherapy and podophyllotoxin 0.15% cream. As the lumps were not responding to conventional wart treatment, a biopsy from these lesions was performed. The histological appearance showed focal fibrin thrombus formation within dilated vascular channels consistent of a subepidermal cavernous haemangioma.

This case demonstrates that the clinical diagnosis of anogenital warts is not always straightforward. It highlights the importance of obtaining a tissue diagnosis from the resistant or atypically looking warty lesions to avoid making the wrong diagnosis.

Key Words: anogenital warts • vulval lumps • subepidermal cavernous haemangioma • diagnosis

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