Anterior vaginal cyst mimicking pelvic organ prolapse: Case report and literature review.

INTRODUCTION AND IMPORTANCE: Large Anterior vaginal cysts can manifest as symptomatic genital prolapse, posing a diagnostic challenge due to their uncommon clinical presentation. CASE PRESENTATION: A 22-year-old primiparous woman with no previous medical history is admitted for delivery. Examination revealed a cystic mass on the anterior vaginal wall. Perineal ultrasound confirmed an independent cyst measuring 45x40x35 mm. The cyst was successfully aspirated, and the patient delivered without complications. At 12 months, the cyst reappeared, requiring vaginal surgical excision. Histological examination identified a Gartner cyst. During follow-up at 6 and 12 months, the patient remained asymptomatic. CLINICAL DISCUSSION: Vaginal cysts typically present as small, solitary, and symptomless. However, they can grow in size, mimicking other conditions and often being misdiagnosed as cystoceles. Consequently, surgical excision of the vaginal cysts is the preferred treatment option, yielding positive anatomical outcomes and high patient satisfaction levels. CONCLUSIONS: In this report, we describe a rare case of a Gartner cyst found on the anterior vaginal wall. The report also underscores the crucial role of imaging in accurately identifying the cyst's location, assessing its association with adjacent tissues, and guiding the surgeon in devising an effective operative plan.

A Large Mullerian Cyst With Pressure Symptoms: A Case Report.

Mullerian cysts are of embryological origin and are usually found incidentally during delivery or a routine gynecological examination. They remain asymptomatic unless they become large enough to cause heaviness or pressure on the surrounding structures. Here, we present the case of a large 8 × 5 cm vaginal cyst that presented with bladder and bowel pressure symptoms. Complete vaginal cyst excision through the vaginal route was done to prevent its recurrence. The histopathology report showed ciliated columnar mucinous epithelium and confirmed the vaginal cyst as a cyst of Mullerian origin.

Vaginal cysts: An important differential diagnosis in the anterior compartment.

INTRODUCTION: Benign anterior-vaginal-wall cysts (0.5-1% prevalence) often mimic other structures (e.g. cystoceles). No algorithm for their diagnosis, treatment, recurrence or complication prediction can be derived from existing data. Careful preoperative diagnosis can minimize intraoperative surprises and complications due to differences in cyst origin. METHODS: This retrospective study was performed with data from consecutive patients with anterior vaginal cysts who underwent surgery at the Pelvic Floor Centre, University Women's Hospital of Jena, within a period of 7 years. Data on patient age, symptoms, history of previous surgery, lesion characteristics, preoperative imaging findings, surgeries, postoperative stays, complications and histological and microbiological findings were collected. RESULTS: Out of 797 consecutive anterior vaginal prolapse repairs 19 (2.4%) anterior vaginal cystic lesions were found, mean age 47 [standard deviation (SD) 14, range 22-72] years. Symptoms reported were pressure (58%), voiding dysfunction (26%), dyspareunia (5%) and inflammation signs (37%); 26% of cases were asymptomatic. Two patients had received prolapse pessary treatment before. Two patients had history of previous vaginal surgery. Five cases were diagnosed preoperatively by ultrasound. Cysts were located on the medial anterior vaginal wall (42%), suburethral (42%) and the vaginal apex (16%). The mean lesion size was 2.6 (SD 0.9) cm. Eleven percent of cases showed microbiological positivity. Most (89%) vaginal cysts were excised; 11% were fenestrated, biopsied and drained. Twenty-six percent of patients underwent outpatient procedures; for inpatient procedures, the median stay was 2.7 days. Postoperative hemorrhage with no transfusion requirement occurred in one patient. All lesions were benign. CONCLUSIONS: Anterior-compartment vaginal cysts can be found incidentally during pelvic organ prolapse assessment and surgery, as they can mimic anterior-vaginal-wall prolapse. In this cohort, all excised lesions were benign.

Paraurethral cyst with multiple stones: A Case report.

Paraurethral cyst is a rare cystic condition that presents in the distal wall of the vagina. Stone formation in parauretheral cyst is rare (Blaivas et al., 2004) [1]. We report a Case of a 64-year-old multiparous, post-menopausal woman who presented with complaints of a hard swelling in the vagina and heaviness for 15 years. Cystourethroscopy and excision of the paraurethral cyst was planned. The cyst was opened, and multiple small stones along with the cyst wall were removed. The ureteroscopy was repeated, and the urethra was intact after cyst removal. She was seen a month later, and the patient was voiding well.

Large cyst of the vaginal wall in pregnancy.

Large vaginal cysts during pregnancy are rare and can mislead Obstetricians to a false diagnosis, that of "Protruding membranes". Aspiration of the cyst can be easily performed, resulting in the collapsing of the cyst and an uneventful vaginal delivery can be conducted.

Clinical Manifestations and Outcomes in Surgically Managed Gartner Duct Cysts.

STUDY OBJECTIVE: Gartner duct cysts (GDCs) are rare embryological remnants of the mesonephric duct with the majority of cases discovered incidentally in asymptomatic patients. The largest prior published series evaluating the surgical management of GDCs included 4 patients. The present study aimed to determine the manifestations and outcomes of surgically managed patients with GDCs with important implications for surveillance, monitoring, and management. DESIGN: A retrospective chart review (Canadian Task Force classification III). SETTING: A tertiary care center. PATIENTS: All women diagnosed with GDCs from January 1994 to April 2014 at our institution were identified. Patients were included if they underwent surgical management and had GDCs confirmed by pathology. One hundred twenty-four charts were manually reviewed, and 29 patients were included in the analysis. INTERVENTIONS: All patients underwent surgical management, which included vaginal excision or marsupialization. MEASUREMENTS AND MAIN RESULTS: A total of 29 patients met the inclusion criteria for this study. The median age of the patients included in the analysis was 36 years old. Eleven patients were asymptomatic at the time of diagnosis (37.9%). The reason for surgical intervention was not available in 9 of these patients. Surgical intervention was performed in 2 of the 11 asymptomatic patients because of an increasing size of the lesion during observation. Presenting symptoms included dyspareunia or pain with tampon placement (37.9%), pelvic pain or pressure (24.1%), pelvic mass or bulge (17.2%), and urinary incontinence (6.9%). Preoperative imaging studies were obtained in 62% of patients; ultrasound was used in 44.4%, computed tomographic scanning in 22.2%, magnetic resonance imaging in 16.7%, and multiple modalities in 16.7%. Approximately 10% were found to have other genitourinary anomalies, including a bladder cyst, urethral diverticulum, and a solitary right kidney with uterine didelphis and septate vagina. The average cyst size was 3.5 cm (±1.8 cm). Surgical excision of GDCs was performed in all except for 3 cases of marsupialization. No intraoperative complications occurred. The median follow-up was 82 months (range, 0-246 months). One patient had possible recurrence with dyspareunia and protruding tissue diagnosed 14 months postoperatively. There were no other postoperative complications in the follow-up period. CONCLUSION: GDCs are rare pelvic masses that are often asymptomatic but may present with dyspareunia, pelvic pain or pressure, pelvic mass or bulge, or urinary symptoms. Excision or marsupialization is successful in the majority of cases without significant morbidity.

Isolated Vaginal Neurofibroma Presenting as Vaginal Wall Cyst: A Rare Case Report With Review of Literature.

Neurofibromas commonly involve peripheral nervous system. Isolated neurofibroma of vagina is very rare tumor and usually associated with Von Recklinghausen's disease. Vulva is the most frequent location of neurofibroma of genital tract followed by clitoris and labia. We present a rare case of neurofibroma of vaginal wall presented as vaginal cyst in a 52 year old female with no history of any other symptoms related to Recklinghausen's disease. Excision biopsy was done and on the histopathological examination non-encapsulated, well circumscribed mass composed of spindle shaped cells with wavy nuclei and bland nuclear chromatin was noted. Immunohistochemistry revealed strong positivity with S-100.

Imperforate hymen presenting as vaginal cyst in a 16-month-old child - considerations for an early diagnosis.

Imperforate hymen is a congenital anomaly of female external genitalia, which is mostly diagnosed in puberty, at the age of 9-13 years, or very rarely at a younger age. Clinical picture varies from abdominal pain and low back pain to acute urinary retention. We describe a case of a 16-month-old female infant where the imperforate hymen presented as a vaginal cyst. The cyst was first observed by the patient's mother, although the child had been examined by a paediatrician on several occasions after birth. Complete workup performed for differential diagnosis, mostly to exclude other reproductive system anomalies, led to the final diagnosis of imperforate hymen. The aim of this report is to emphasise the necessity of thorough examination of genitalia in female newborns in order to avoid possible complications associated with this diagnosis later in life, as well as other, more severe differential diagnostic anomalies.

Urethral Diverticulum Masquerading as Anterior Vaginal Wall Cyst: A Diagnostic Dilemma.

Urethral diverticulum (UD) is a condition in which a variably sized outpouching forms, next to the urethra. Because it connects to the urethra, this outpouching repeatedly gets filled with urine during micturition, thus causing symptoms. In females, it presents as a bulge in anterior vagina, mimicking a vaginal wall cyst. Various aetiologies proposed attributing to urethral diverticulum formation is repeated infection of the periurethral gland, childbirth trauma, iatrogenic and urethral instrumentation. Patients of UD present with non specific irritative lower urinary tract symptoms such as increased frequency, urgency and dysuria; symptoms may not correlate with the size of the diverticulum. Recurrent cystitis or urinary tract infection is seen in one-third of patients. Pain, hematuria, post-void dribbling, dyspareunia, urinary retention or incontinence is other symptoms. In some cases, there may be associated urethral calculi or carcinoma. Magnetic resonance imaging (MRI) is highly sensitive and specific for the diagnosis of UD, although non invasive sonography may be the first line investigation. Treatment is by transvaginal diverticulectomy or marsupialization. A 60-year-old P9L6 postmenopausal lady, presented with a tender, hard suburethral anterior vaginal wall mass. Cystourethroscopy revealed a small opening in posterior urethra, with stone visible through it. With the final diagnosis of suburethral diverticulum with retained multiple calculi, excision of the diverticulum and repair of urethra was done vaginally. Correct evaluation and treatment of this condition can lead to avoidance of urinary tract injury.

Posterior vaginal wall Gartner's duct cyst.

Cyst of posterior vaginal wall is very rare. This case relates to a patient who presented with polypoidal mass protruding out from vagina which could have been easily mistaken as uterovaginal prolapse, but appropriate clinical evaluation supported with investigations clinched the diagnosis easily.

Intracystic hemorrhage in a non-endometriotic mullerian vaginal cyst.

The commonest type of simple vaginal cyst is the Mullerian cyst. These are typically lined by columnar epithelium and contain serous or mucinous fluid. If blood is found in the cyst, the source is usually due to the presence of endometrial elements in the cyst wall. The cyst is then termed an endometriotic cyst. In this case report, we have described a woman with a symptomatic 3 cm upper vaginal cyst who underwent surgical excision of the cyst. The cyst cavity was found to be full of old dark blood and mucous, however the wall contained no endometrial tissue and was lined by columnar epithelium which stained positive for mucous with mucicarmine. No cause for the intracystic hemorrhage was identified. We conclude that intracystic hemorrhage can occur in a simple Mullerian vaginal cyst in the absence of endometrial components.

Recién nacida con tumoración genital interlabial de resolución espontánea: Caso clínico / Newborn with genital interlabial mass with spontaneous resolution: Case report

Las tumoraciones interlabiales en las recién nacidas son temas infrecuentes, de interés para pediatras, cirujanos, urólogos, dermatólogos y ginecólogos infantiles. Los quistes interlabiales neonatales más frecuentes son los quistes himeneales y los quistes glandulares parauretrales. Varias tumoraciones interlabiales, incluyendo las de origen embrionario, tejido ectópico, prolapso, anomalías urinarias o neoplasias, pueden aparentar ser simples quistes. Entre estos están el prolapso de uretra, vagina o útero, el ureterocele ectópico, el quiste del conducto de Gartner, el hidrometrocolpos asociado a himen imperforado y el rabdomiosarcoma botroide. El diagnóstico diferencial es importante tanto para el enfoque terapéutico como por el seguimiento. Se presenta el caso de una niña de 3 días de edad con diagnóstico de quiste himeneal y sus posibles diagnósticos diferenciales.

Interlabial masses of newborns are rare issues that fall into the interest of pediatricians, pediatric surgeons, urologists, dermatologists and gynecologists. The most common are the hymenal cysts and paraurethral gland cysts. Several interlabial masses, including those of embryological origin, ectopic tissue, prolapse, urological anomaly, or neoplasia, can superficially resemble simple cysts. These include prolapsed urethra, prolapsed ectopic ureterocele, prolapsed vagina or uterus, Gartner's duct cyst, hydrometrocolpos associated with an imperforate hymen and botryoid rhabomyosarcoma. The differential diagnosis is important both for treatment approach and for follow up. We present a 3- day- old baby girl patient diagnosed with hymenal cyst.

Recién nacida con tumoración genital interlabial de resolución espontánea: Caso clínico / Newborn with genital interlabial mass with spontaneous resolution: Case report

Las tumoraciones interlabiales en las recién nacidas son temas infrecuentes, de interés para pediatras, cirujanos, urólogos, dermatólogos y ginecólogos infantiles. Los quistes interlabiales neonatales más frecuentes son los quistes himeneales y los quistes glandulares parauretrales. Varias tumoraciones interlabiales, incluyendo las de origen embrionario, tejido ectópico, prolapso, anomalías urinarias o neoplasias, pueden aparentar ser simples quistes. Entre estos están el prolapso de uretra, vagina o útero, el ureterocele ectópico, el quiste del conducto de Gartner, el hidrometrocolpos asociado a himen imperforado y el rabdomiosarcoma botroide. El diagnóstico diferencial es importante tanto para el enfoque terapéutico como por el seguimiento. Se presenta el caso de una niña de 3 días de edad con diagnóstico de quiste himeneal y sus posibles diagnósticos diferenciales.(AU)

Interlabial masses of newborns are rare issues that fall into the interest of pediatricians, pediatric surgeons, urologists, dermatologists and gynecologists. The most common are the hymenal cysts and paraurethral gland cysts. Several interlabial masses, including those of embryological origin, ectopic tissue, prolapse, urological anomaly, or neoplasia, can superficially resemble simple cysts. These include prolapsed urethra, prolapsed ectopic ureterocele, prolapsed vagina or uterus, Gartners duct cyst, hydrometrocolpos associated with an imperforate hymen and botryoid rhabomyosarcoma. The differential diagnosis is important both for treatment approach and for follow up. We present a 3- day- old baby girl patient diagnosed with hymenal cyst.(AU)

Quiste gigante de la glándula de Bartolino: reporte de caso y revisión de la literatura / A case report and literature review regarding giant Bartholin gland cyst

Introducción: en el presente artículo se expone el caso de una paciente que tuvo un quiste gigante de la glándula de Bartolino, el cual alcanzó un diámetro de 10 cm. La paciente presentó algunas dificultades diagnósticas y terapéuticas por lo que fue necesaria la escisión de la glándula y la posterior reconstrucción de la vulva. El diagnóstico definitivo fue establecido por anatomía patológica. El caso se presenta con el objetivo de realizar una revisión de la literatura respecto al tratamiento. Materiales y métodos: se realizó una búsqueda de la literatura relacionada con el tema en las bases de datos electrónicas PubMed, SciELO, ScienceDirect y MD Consult, utilizando las palabras clave: "glándulas de Bartolino", "quistes" y "marsupialización". Además, se revisaron referencias de libros de textos. Conclusiones: la urgencia en el tratamiento depende de los síntomas de la paciente. Un quiste asintomático podría no requerir tratamiento. Sin embargo, la no mejoría dentro de las primeras 72 horas o la evolución hacia una forma de absceso requerirá un tratamiento quirúrgico de emergencia. Se ha descrito una amplia variedad de tratamientos que incluyen una serie de procedimientos quirúrgicos tales como: 1) incisión simple y drenaje, 2) fistulización o marsupialización, 3) colocación de un catéter de Word, 4) escleroterapia con alcohol, 5) aplicación de nitrato de plata y 6) ablación del quiste utilizando dióxido de carbono (CO2 ) con láser.

Introduction: the case of a patient who had a giant Bartholin gland cyst is presented; it reached 10 cm diameter, presenting some diagnostic and therapeutic difficulties, requiring the excision of the gland and later reconstruction of the vulva. Definitive diagnosis was established by pathological anatomy. The case is presented as it led to a review of the pertinent literature regarding the relevant treatment. Materials and methods: a search was made of the pertinent literature in PubMed, SciELO, ScienceDirect and MD Consult databases, using the key words "Bartholin glands", "cysts", "marsupialization". Pertinent reference books were also reviewed. Conclusions: the urgency of treatment depends on a particular patient's treatment. An asymptomatic cyst may not require treatment; however, if there is no improvement within the first 72 hours or it evolves towards an abscess, then it will require emergency surgical treatment. A broad variety of treatments has been described which includes a series of surgical procedures, which include: simple incision and drainage, fistulization or marsupialization, placing a Word catheter, sclerotherapy with alcohol, applying silver nitrate and cyst ablation using carbon dioxide (CO2) laser.

A Gartner duct cyst of the vagina causing dysuria and dyschezia in a Yorkshire Terrier

A 5 year-old, intact female Yorkshire terrier was referred for dysuria and dyschezia. The radiographic and ultrasound examination showed a round shaped mass caudal to the urinary bladder that contained anechoic fluid within the thin walls. During surgery, the cyst was noted to be attached to the outer wall of the vagina, not connected to the vaginal lumen. Cystic fluid was removed and the cystic wall was resected. Then the remaining cystic wall was omentalized to prevent a recurrence. Histological examination confirmed that the cyst was of Wolffian duct origin. In this case, a large Gartner duct cyst causing urological problems was diagnosed and removed by surgical resection.

A Case of Vaginal Tuberculosis presenting as Vaginal Cyst / 대한산부인과학회지

A rare case of vaginal tuberculosis is reported. A 42-year-old woman referred to our hospital for surgical treatment of a cystocele presented with vaginal mass for 2 months. Pelvic examination revealed a cystic mass at anterior vagianl wall. Her initial diagnosis was urethral diverticulum. Surgical excision was performed and pathological analysis of the specimen revealed tuberculosis. She was treated with antituberculous drugs. We emphasize the need to maintain a high index of suspicion and to biopsy any suspicious vaginal lesion in the diagnosis of vaginal tuberculosis.