THE UTILITY OF SUBMITTING FIBROEPITHELIAL POLYPS FOR HISTOLOGICAL EXAMINATION

Background: The fibroepithelial polyp (FEP) is a common cutaneous lesi on that is often removed for medical or cosmetic reasons. We examined the utility of submitting clinically diagnosed FEPs for routine micros copic examination. Design: We reviewed 11 500 consecutive cutaneous pa thology reports. Materials submitted with the clinical diagnosis of FE P or a synonym were reviewed and the histopathologic slides were exami ned. A comparison group of specimens submitted with the clinical diagn osis of melanocytic nevus was reviewed. Setting: The biopsy reports we re generated at a regional non-hospital-based dermatopathology laborat ory providing service to physicians (dermatologists and nondermatologi sts) practicing ambulatory medicine predominantly within a 4-state reg ion (Ind, Ky, Tenn, and WVa). Results: Of 1335 clinical specimens subm itted as FEPs, there were 5 malignant tumors. In the comparison group of 697 clinically diagnosed melanocytic nevi, there were 6 malignant t umors. In comparison with clinically diagnosed melanocytic nevi, the l ikelihood that a lesion clinically diagnosed as FEP would be a maligna nt tumor on histological examination is very low (relative risk, 0.4). None of the lesions clinically diagnosed as FEPs by dermatologists pr oved to be malignant. Conclusions: Our data suggest there is an extrem ely low prevalence of malignancy in lesions clinically diagnosed as FE Ps. We conclude that cutaneous lesions diagnosed as typical FEPs by de rmatologists need not be submitted for microscopic examination.