A 24-year-old girl complains of a vaginal discharge and a fleshy object protruding from the vulva at times. This interferes with sexual intercourse. She has been treated with pessaries and antibiotics for suspected venereal disease.

A longstanding, soft, multinodular pendulous, slightly ulcerated mass hanging out of the vagina and attached to the vaginal and labia is usually a vaginal fibroma. The differential diagnosis would be other tumours of the vulva, and in older women a similar appearance could occur from a solitary skin tag or squammous papilloma, which are also benign.

This innocent tumour composed chiefly of connective tissue is a benign condition and can be present for a long time without much complaint by the patient. Secondary ulceration or infection will produce a vaginal discharge which needs to be investigated and treated.

Treatment of the lesion is simple excision at its base and there is no evidence that it will recur or become malignant. In this case it was cut off under local anaesthetic and there was no further complaints from the patient. She was referred to the STD clinic for a vaginal discharge.