Methods:
The findings suggested the differential diagnosis of Squamous cell carcinoma, Basal cell carcinoma, and fibroma (fig .1). Laboratory test results include hemoglobin (9.1 g/dl), Blood Sodium (129 mEq/L), and Blood calcium (1.28 mg/dL).
Transvaginal ultrasonography (TVUS) demonstrated a normal uterus that contains a paragard intrauterine device(IUD), normal left adnexa, and an enlarged right ovary. On spiral computed tomography scan with intravenous (IV) and oral contrast, the presence of a gallstone, an oval-shaped cyst(4*7cm) on the right uterine adnexa, irregular, central necrosis, oval mass(15*7*17cm) on the right labia majora, and a right iliac lymphadenopathy is observed (fig .2).
An excisional biopsy was performed. The pathological examination result confirmed the diagnosis of a benign fibroma with ulcerative epithelium covering the surface of the mass, subepithelial inflammatory infiltration which consists of lymphocytes, plasma cells, and fibroblasts, with edema in the stroma, and no evidence of malignancy (fig .3).