DOI: https://doi.org/10.36347/sjmcr.2026.v14i10.034

Pages: 2264-2268

Vulvar tuberculosis is an exceptionally rare manifestation of female genital tuberculosis and may mimic vulvar malignancy, making diagnosis challenging. A 46-year-old multiparous perimenopausal woman with poorly controlled insulin-treated type 2 diabetes mellitus presented with a one-month history of an extensive vulvoperineal lesion. Examination revealed marked hypertrophy of the labia majora extending to the anoperineal and inguinal regions, measuring approximately 10 × 5 cm, with additional nodular lesions on the posterior vaginal wall. Biopsy demonstrated epithelioid and multinucleated giant-cell granulomas with caseous necrosis, consistent with tuberculosis. Chest radiography showed no pulmonary involvement. The patient received standard antituberculous therapy for six months, with marked regression of the vulvar lesions. Vulvar tuberculosis should be considered in the differential diagnosis of atypical hypertrophic or pseudotumoral vulvar lesions, even in the absence of pulmonary disease. Histopathological examination remains essential, while microbiological or molecular testing should be pursued when feasible to support diagnosis and guide management appropriately.