Vulvar fibroma

　　1. Etiology

　　Vulvar fibroma is a benign polypoid mass formed by the outward protrusion of loose connective tissue from the skin surface.

　　2. Pathogenesis

　　Vulvar fibroma is a benign polypoid mass formed by the outward protrusion of loose connective tissue from the skin surface. The tumor surface has wrinkles and is soft in texture. It is polypoid with a white, soft fibrous connective tissue in cross-section. Under the microscope, it can be observed that there is a significant component of fibrovascular stroma in the vulvar germinative epithelium, covered by relatively normal or atrophic squamous epithelium. Papillary hyperplasia and hyperkeratosis may also occur. The mesenchymal components can vary greatly from case to case, with some cases having few cell components scattered in loose mucinous edematous stroma with mild-shaped spindle cells. In some cases, there are many cells, without a clear boundary between the epidermis and mesenchyme, with obvious polymorphism, a large number of atypical large cells, and multinucleated cells, and there may be a significant increase in nuclear division. Immunohistochemical staining shows positive desmin, vimentin, and partial actin, and the stromal cells can be positive for ER and PR.

　　Vulvar fibroma is most commonly found on the labia majora, which can be solitary or multiple. Clinically, it often presents no symptoms and is discovered during palpation or inspection. The tumor is typically rounded, polypoid, often pedunculated, with many surface wrinkles. Some may resemble condyloma acuminatum. It can persist for many years, and a few may develop into large fibromas. Ulcers can occur when blood supply is insufficient, and symptoms may appear when the pedicle twists or breaks, mainly pain, ulceration, bleeding, and infection. Sometimes, the mass may cause discomfort due to friction. Vulvar fibroma infection can spread and lead to vaginitis.

　　Vulvar fibroma is most commonly found on the labia majora, which can be solitary or multiple. Clinically, it often presents no symptoms and is discovered during palpation or inspection. The tumor is typically rounded, polypoid, often pedunculated, with many surface wrinkles. Some may resemble condyloma acuminatum and can persist for many years. A few may develop into large fibromas. Ulcers can occur when blood supply is insufficient, and symptoms may appear when the pedicle twists or breaks, mainly pain, ulceration, bleeding, and infection. Sometimes, the mass may cause discomfort due to friction. Small soft warts are similar to dermatofibromas, originating from isolated hard collagen, and may also appear as polypoid vulvar injury.

　　1. Regular physical examination: for early detection, early diagnosis, and early treatment.

　　2. Do a good follow-up: prevent the deterioration of the condition.

　　3. Pay attention to personal hygiene, especially the hygiene of the female genitalia during menstruation and puerperium.

　　4. Strengthen physical fitness and improve self-immunity: Pay attention to the combination of work and rest, participate in more physical exercise, and eat more fresh fruits and vegetables rich in vitamins.

　　Prognosis: Vulvar fibroma is rarely malignant; local recurrence may occur if it is not completely removed.

　　The diagnosis of vulvar fibroma relies not only on clinical manifestations but also on corresponding auxiliary examinations, which are indispensable.

     1. Routine examination of vaginal discharge, tumor marker examination.

　　2. Histopathological examination.

　　I. Dietetic Recipe for Vulvar Fibroma

　　1. Baibao Porridge

　　Ingredients: 15 grams each of Codonopsis pilosula and Atractylodes macrocephala, 50 grams each of Poria cocos, Rhizoma dioscoreae, Euryale ferox, lotus seeds, Job's tears, 10 dates, 100 grams of glutinous rice, and appropriate amount of sugar.

　　Preparation: Remove the core of lotus seeds, add water to the herbs, boil for 30 minutes, strain out the渣 of Codonopsis pilosula and Atractylodes macrocephala, add glutinous rice and sugar to cook porridge.

　　Effects: Tonify the middle Qi. Suitable for cancer patients with decreased appetite after surgery or chemotherapy and radiotherapy, lack of appetite, fatigue, excessive sweating, bloating after eating, and loose stools.

　　2. Ginseng and Cornu Cervi Stewed Turtle

　　Ingredients: 500 grams of turtle meat, 10 grams of ginseng, 3 grams of cornu cervi, 50 grams of Job's tears, and appropriate amount of seasoning.

　　Preparation: Kill the turtle, remove the head, claws, and internal organs, clean and cut into pieces, place the wrapped herbs in the pot with ginger and water, remove the foam after boiling, add cooking wine and lard, and simmer over low heat until the meat is tender, season with salt and monosodium glutamate as needed.

　　Effects: Tonify Qi and Yang, nourish Yin and fill essence. Suitable for cancer patients with weak Yang and for those with decreased red and white blood cells after chemotherapy and radiotherapy. Symptoms include weakness, aversion to cold, cold limbs, and lack of energy, as well as lack of spirit.

　　3. Lycium Turtle Soup

　　Ingredients: 300 grams of turtle meat, 30 grams of Lycium barbarum, 15 grams of Rehmannia glutinosa, 10 grams of Astragalus membranaceus, and appropriate amount of seasoning.

　　Preparation: Kill the turtle, remove the shell, head, and claws, clean and cut into pieces, place in a sand pot, add water and wrapped herbs, bring to a boil with strong fire, then simmer over low heat until the meat is tender, remove the herb package, and season with salt and monosodium glutamate as needed.

　　Effects: Tonify Qi and nourish Yin. Suitable for cancer patients with insufficient Qi and Yin, and for those with decreased red and white blood cells after chemotherapy and radiotherapy. Symptoms include emaciation, fatigue, dry mouth, night sweats, and weakness in the lower back and knees.

　　4. Baizhen Chicken Soup

　　Ingredients: 1000 grams of hen, 6 grams each of Angelica sinensis, Radix Paeoniae alba, Rehmannia glutinosa, Ligusticum chuanxiong, Atractylodes macrocephala, and Glycyrrhiza uralensis, 10 grams each of Codonopsis pilosula and Poria cocos, 3 slices of ginger, and appropriate amount of seasoning.

　　Preparation: Clean the chicken, cut into pieces, place in a sand pot, add ginger, various herbs (wrapped in cloth) and an appropriate amount of water, bring to a boil with strong fire, then simmer over low heat until the chicken is tender, remove the herb package, season with salt, pepper, and monosodium glutamate, and it is ready.

　　Effect: Tonify both Qi and blood. Suitable for tumor patients with decreased red and white blood cells after surgery and radiotherapy or chemotherapy. Manifested as pale complexion, dry throat and mouth, shortness of breath upon exertion, palpitations, insomnia, etc.

　　5. Angelica Sinensis and Notoginseng Stewed Chicken

　　Ingredients: 500 grams of hen, 10 grams of Angelica sinensis, 10 grams of notoginseng, season appropriately.

　　Preparation: Clean the chicken, cut into pieces, put in a pot, add ginger, all the herbs (wrapped in cloth) and an appropriate amount of water, boil with high heat, then simmer over low heat until the chicken is tender, remove the herb bag, and add salt, pepper, and monosodium glutamate.

　　Effect: Activate blood circulation and nourish blood. Suitable for patients with tumor blood stasis as the main symptom. Manifested as subcostal or local mass, hard texture, fixed pain, purple tongue, thin and涩脉, etc.

　　6. Rice Flour and Job's Tears Porridge

　　Ingredients: 50 grams of rice flour, 50 grams of Job's tears, 100 grams of yam, 100 grams of glutinous rice, 10 grams of lalang leaves, 10 grams of Zhejiang bletilla powder.

　　Preparation: Cut yam into slices, soak Job's tears in water, wrap the leaves of lalang in a cloth and soak them open, add glutinous rice and cold water to a boil, then add rice flour and Zhejiang bletilla powder to mix evenly, and cook porridge.

　　Effect: Resolves phlegm and relieves dampness. Suitable for patients with severe tumor phlegm and dampness. Manifested as loss of appetite, thick phlegm, sticky mouth, chest and epigastric stuffiness, body weight, fatigue, white and thick fur, slippery pulse, etc.

　　7. Snake Lily Meat Soup

　　Ingredients: 30 grams of snake gourd grass, 20 grams of Job's tears and half-leaf herb, 100 grams of lean pork, season appropriately.

　　Preparation: Wash pork, cut into small pieces, soak Job's tears, and wrap the rest of the medicine in a cloth. Boil pork and medicine package with an appropriate amount of water, then simmer over low heat until the meat is tender, remove the medicine residue, and add the powder and salt and monosodium glutamate.

　　Effect: Clear heat, detoxify, and relieve dampness. Suitable for patients with severe cancer toxin. Manifested as cancerous fever, thirst, shortness of urine, etc.

　　II. Foods that are good for the body when eating vulvar fibroma

　　1. Eat more foods that have the effect of anti-vulvar tumor and leukoplakia, such as sesame, almond, wheat, barley, loofah, black-bone chicken, cuttlefish, black rat snake, pork pancreas, chrysanthemum, umeboshi, peach, lychee, portulaca, chicken blood, eel, abalone, crab, horseshoe crab, sardine, clam, tortoise shell, etc.

　　2. For pain, eat horseshoe crab, red, lobster, clam, sea cucumber, tiger fish, beetroot, mung bean, radish, chicken blood, etc.

　　3. To relieve itching, eat amaranth, cabbage, mustard, taro, kelp, seaweed, chicken blood, snake meat, pangolin, etc.

　　4. To enhance physical fitness and prevent metastasis, eat silver ear, black fungus, mushroom, hedgehog mushroom, gizzard, sea cucumber, Job's tears, walnut, crab, lizard, needlefish, etc.

　　5. After surgery for vulvar fibroma, as it consumes Qi and injures blood, it is advisable to eat more foods that nourish Qi and blood, such as jujube, longan, adzuki bean, glutinous rice, lychee, mushroom, carrot, quail egg, lotus root starch, beans, etc.

　　III. Foods to avoid for vulvar fibroma

　　1. Avoid smoking, drinking, and spicy刺激性 foods.

　　2. Avoid greasy, fried, moldy, and preserved foods.

　　3. Avoid foods that may trigger an outbreak, such as rooster and goose.

　　4. Avoid seafood and刺激性, allergenic foods when there is severe itching.

　　5. Avoid warm and spicy foods such as mutton, chive, ginger, pepper, cassia bark, etc. when there is severe itching.

　　I. Prevention:

　　1. Regular physical examination: for early detection, early diagnosis, and early treatment.

　　2. Do a good follow-up: prevent the deterioration of the condition.

　　3. Pay attention to personal hygiene, especially the hygiene of the female genitalia during menstruation and puerperium.

　　4. Strengthen physical fitness and improve self-immunity: Pay attention to the combination of work and rest, participate in more physical exercise, and eat more fresh fruits and vegetables rich in vitamins.

　　Second, before treatment:

　　It is necessary to understand the symptoms of the disease and related contraindications in detail.

　　Third, Traditional Chinese Medicine Treatment Methods for Vulvar Soft Fibroma

　　Choose to apply Five Miraculous China Paste, Crystal Paste, or Moles Remover Cream to the affected area until it falls off.

　　1. Five Miraculous China Paste:

　　Treatment Principle:

　　It mainly acts directly on the affected area, causing the protein of the lesions to coagulate, blood vessels to occlude, tissue to atrophy, volume to shrink, and keratin to dissolve. It has an eliminating effect on hyperplastic lesions. It stimulates nerve endings, improves blood circulation, promotes tissue regeneration, accelerates wound healing. It has strong bactericidal, anti-inflammatory, and rapid healing effects. It stops bleeding, itching, and pain. There are no traces after healing.

　　2. Crystal Paste:

　　Treatment Principle:

　　Grind 15g of calcined lime into fine powder and soak it in concentrated alkali water (about 100ml), with alkali water 2 fingers above the lime surface. Sprinkle 50 grains of glutinous rice on the lime. Soak for one day and one night, remove the rice, and beat it into a paste. Apply twice a day in winter. Apply the crystal paste to the skin lesion, do not hurt the normal skin, and it can be healed after the scab falls off.

　　3. Moles Remover Cream:

　　Treatment Principle:

　　The main ingredients are lime, high-concentration white wine, Yunnan Baiyao, and camphor, mixed together. It can corrode the tumor mass when applied to the vulvar soft fibroma.

　　Fourth, Western Medicine Treatment Methods for Vulvar Soft Fibroma

　　1. Surgical resection is the main treatment, and for larger tumors with pedicle damage, resection at the root can be performed without anesthesia in most cases. Generally, resection is along the base, and if bleeding occurs, aluminum chloride can be used externally for hemostasis. If the patient is worried about the tumor, symptoms appear, or the tumor diameter exceeds 1-2 cm, the tumor should be resected.

　　2. For multiple small lesions of vulvar soft fibroma, laser, electrocoagulation, electrocautery, or liquid nitrogen freezing can be used instead of traditional surgery. Liquid nitrogen freezing is very effective.

　　(1) Chemical cautery: Phenol or trichloroacetic acid can be locally applied to corrode the tumor mass.

　　(2) Treatment methods such as liquid nitrogen cryo-coagulation or laser can be used.

　　(3) Electric desiccation can be used for larger skin lesions under local anesthesia.

　　Similarly, the excised tissue should be sent for pathological examination.