Endometriotic Foci in Bartholin's Cyst

Abstract

Abstract

Background: Endometriosis is a condition in which endometrial glands and stroma grow outside the endometrial cavity. Although endometriotic deposits are most often found within the pelvis, implants may rarely occur at several other sites. Endometriotic implants in the vulva and Bartholin's gland are very unusual. Case: A 35-year-old parous woman presented to the urogynecology clinic of the KK Women's and Children's Hospital, Singapore, with a lump arising through her vagina since a normal vaginal delivery 4 years prior. On examination, a 4 × 4 cm fluctuant, nontender vaginal cyst was noted in the lower one-third of the vagina on the left lateral side, close to an episiotomy scar. She was counseled to undergo excision of the cyst and she consented to do so. The cyst wall was inadvertently ruptured during the procedure, and a thick chocolate-colored fluid poured out from within the cyst. The cyst wall was excised and the dead space and vulval skin were closed. Results: The patient recovered well. The histopathologic examination was consistent with a Bartholin's cyst with endometriotic foci. Conclusions: Vulvar endometriosis should be considered as a possible, although rare cause of cystic masses of the vulva, especially those associated with variability in size and tenderness during the menstrual cycle. Surgical excision and histopathologic examination is necessary to establish a definitive diagnosis. (J GYNECOL SURG XX:1)