Objective: Vulvar varicosities are not uncommon in pregnancy, but there are only a few published reports of symptomatic vulvar varicosities in nonpregnant women.
Case: We report 2 cases of women presenting with symptomatic vulvar masses that were more prominent after exercise or with elevated intra-abdominal pressure. Symptoms included an intermittent vulvar bulge or mass and moderate pain when the masses were present. Imaging studies did not reveal the nature of these masses. On surgical exploration, they were found to be large vulvar varicosities.
Conclusions: Vulvar masses can be caused by hernias, tumors, cysts, or other unusual entities. Differentiating among these etiologies can be a diagnostic challenge. Although most often a positional vulvar mass is a sign of hernia, it is important to be aware that masses that come and go can be caused by other entities, including large varicose veins.