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Enterobious Vermicularis (Pinworm) Infestation of the Vulva: Report of 2 Cases of a Pseudoneoplastic Lesion Mimicking Squamous Carcinoma

Konanahalli, ; Menon, ; Walsh, ; McCluggage,

International Journal of Gynecological Pathology: September 2010 - Volume 29 - Issue 5 - p 490–493
doi: 10.1097/PGP.0b013e3181d208fb

Enterobious Vermicularis (pinworm) infestation outside the gastrointestinal tract is rare. We report 2 patients with vulval involvement, one of whom presented with a clinically suspicious, rapidly growing mass. The histology of both lesions showed similar features of epidermal proliferation in the form of hyperkeratosis, acanthosis, and papillomatosis; this pseudoepitheliomatous hyperplasia raised the possibility of a well-differentiated squamous carcinoma. There was associated inflammation in both cases, including large numbers of eosinophils in 1 case. On the surface or within the keratin layer, structures with the morphology of enterobious vermicularis eggs were identified. In reporting this unusual pseudoneoplastic phenomenon, we stress the necessity for the pathologist to consider and look for parasites in proliferative squamous lesions of the vulva, especially when there is an associated inflammatory infiltrate rich in eosinophils.

Department of Pathology (P.K., M.Y.W., W.G.M.), Royal Group of Hospitals Trust, Belfast, Northern Ireland

Department of Pathology (P.M.), St Thomas' Hospital, London, England

Address correspondence and reprint requests to W. G. McCluggage, FRCPath, Department of Pathology, Royal Group of Hospitals Trust, Grosvenor Road, Belfast BT12 6BA, Northern Ireland. e-mail:

©2010International Society of Gynecological Pathologists