Abstract
Background: Congenital perineal lipoma is extremely rare and may lead to a misdiagnosis of ambiguous
genitalia. Case Reports: We report on two girls referred to our service for ambiguous genitalia. Patient 1
(17 days old) and patient 2 (2 months old) had unremarkable gestational and perinatal
histories. Both had normal female external genitalia and a 46,XX karyotype. Patient
1 had a polypoid, protruding 3.0 × 2.0 × 1.5-cm phallic-like mass arising at the inferior
border of the left labium majora, and patient 2 had a similar mass of 1.5 × 1.5 × 1.0 cm
at the same site and an imperforate anus. In both cases the mass was removed and found
to be a lipoma. Discussion: To our knowledge, perineal lipoma has been reported only in eleven girls, nine of
them with associated anorectal malformation. Migration and fusion of the labioscrotal
folds and formation of the urorectal septum are simultaneous developmental events
occurring in the same region, which may explain the association of perineal lipoma
and anorectal malformations.
Key words
ambiguous genitalia - perineal lipoma - neonates - sexual differentiation - anorectal
malformation
References
1
Chanda M N, Jamieson M A, Poenaru D.
Congenital perineal lipoma presenting as “ambiguous genitalia”: a case report.
Pediatr Adolesc Gynecol.
2000;
13
71-74
2
Lee P A, Houk C P, Ahmed S F, Hughes I A. International Consensus Conference on Intersex
organized by the Lawson Wilkins Pediatric Endocrine Society and the European Society
for Paediatric Endocrinology .
Consensus statement on management of intersex disorders. International Consensus Conference
on Intersex.
Pediatrics.
2006;
118
e488-e500
3
Nelson C P, Gearhart J P.
Current views on evaluation, management, and gender assignment of the intersex infant.
Nat Clin Pract Urol.
2004;
1
38-43
4
Özcan C, Celik A, Erdener A.
Accessory perineal scrotum associated with anorectal malformation.
BJU Int.
1999;
83
729-730
5
Park K H, Hong J H.
Perineal lipoma in association with scrotal anomalies in children.
BJU Int.
2006;
98
409-412
6
Ramzisham A R, Thambidorai C R.
Perineal hamartoma with accessory scrotum, anorectal anomaly, and hypospadias – a
rare association with embryological significance: case report.
Pediatr Surg Int.
2005;
21
478-481
7
Rattan K N, Pandit S K, Budhiraja S.
Accessory scotum with imperforate anus.
Pediatr Surg Int.
1997;
12
217
8
Redman J F, Ick K A, North P E.
Perineal lipoma and accessory labial fold in female neonate.
J Urol.
2001;
166
1450
9
Shaul D B, Monforte H L, Levitt M A, Hong A R, Peña A.
Surgical management of perineal masses in patients with anorectal malformations.
J Pediatr Surg.
2005;
40
188-191
10
Sule J D, Skoog S J, Tank E S.
Perineal lipoma and the accessory labioscrotal fold: an etiological relationship.
J Urol.
1994;
151
475-477
11
Wester T, Rintala R J.
Perineal lipomas associated with anorectal malformations.
Pediatr Surg Int.
2006;
22
979-981
Prof. M.D., Ph.D. Gil Guerra-Junior
Department of Pediatrics School of Medicine UNICAMP
P.O. Box 611
Campinas, Sao Paulo, 13083-100
Brazil
eMail: gilguer@fcm.unicamp.br