Dermatology: Practical and Conceptual Image Letter | Dermatol Pract Concept. 2024;14(2):e2024072 1 Steatocystoma Simplex of the Vulva Anna Mishina1, Vergil Petrovici2, Ecaterina Foca2,3, Igor Mishin3 1 Department of Surgical Gynecology, Mother and Child Institute, Chisinau, Moldova 2 Department of Pathology, Mother and Child Institute, Chisinau, Moldova 3 Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Moldova Citation: Mishina A, Petrovici V, Foca E, Mishin I. Steatocystoma Simplex of the Vulva. Dermatol Pract Concept. 2024;14(2):e2024072. DOI: https://doi.org/10.5826/dpc.1402a72 Accepted: November 1, 2023; Published: April 2024 Copyright: ©2024 Mishina et al. This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited. Funding: None. Competing Interests: None. Authorship: All authors have contributed significantly to this publication. Corresponding Author: Anna Mishina M.D., Ph.D. str. Muncheshty 52, apt. 60, 2001, Chisinau, Moldova. Tel: (+37322) 83 24 65 Fax: (+37322) 52 20 08 E-mail: anna.mishina2023@gmail.com Case Presentation A 43-year-old female (G-1, A-1) presented to the clinic with a 2-year history of painless swelling in the left labia majora. Perineal examination was normal except for a 2 cm mass in the left labia majora, movable with soft rubbery con- sistency. The skin over the labia was normal, with no vas- cular changes. There was no inguinal lymphadenopathy. Her family history was unremarkable.  Perineal ultrasound demonstrated a unicameral  well-demarcated oval-shaped cyst measuring 29.5 x 13.0 mm in size, with homogeneous, hyperechogenic internal echotexture and no Doppler flow (Fig. 1A). The mass was enucleated with an intact capsule under anesthesia (Fig. 1B, C). The cyst was filled with thick, greasy material. The pathological findings of this mass were consistent with a steatocystoma (Fig. 1D). There was no recurrence during the 7-month follow-up. Teaching Point Steatocystoma is a lesion that results from a hamartoma- tous malformation of the pilosebaceous duct, leading to an epithelium-lined cystic lesion containing sebaceous lob- ules. Steatocystomas can be classified into steatocystoma multiplex (SCM) and steatocystoma simplex (SCS), ac- cording to the multiplicity. SCS was first reported in 1982 by Brownstein, who described 30 cases [1]. In order of de- creasing frequency, these lesions are mostly located on the scalp, face, neck, axillae, chest, upper limbs, back, or lower limbs [1]. In contrast, SCM and SCS in the vulvo-perineal region is extremely rare, with only a few cases reported in the literature [2]. SCS is a rarely benign lesion occur- ring extremely rare on the vulva and should be considered in the differential diagnosis of painful/painless superficial vulvar mass. 2 Image Letter | Dermatol Pract Concept. 2024;14(2):e2024072 References 1. Brownstein MH. Steatocystoma simplex. A solitary steato- cystoma. Arch Dermatol. 1982;118(6):409-11. PMID: 7092252 2. Cunningham SC, Kao GF, Moore GW, Napolitano LM. Steatocystoma simplex. Surgery. 2004;136(1):95-7. DOI: 10.1016 /s0039-6060(03)00341-6. PMID: 15232545 Figure 1. (A) Perineal ultrasound demonstrated a unicameral well-demarcated oval-shaped cyst. (B) Intraoperative view of mass in the left labia majora. (C) The cyst was excised intact. (D) Histo- pathology: the cystic wall is serpiginous, lined by thin squamous epithelium with an outer corru- gated cuticle and minimal granular layer (H&E, x20).