Abstract
BackgroundEpidermoid cysts of the external genitalia are one of the late complications of female genital mutilation. These cysts are usually small and painless. The presentation of a giant vulvar cyst in a postmenopausal woman has not been reported; the surgical management of a large cyst is often challenging.Case presentationA 60-year-old, para VI, Ethiopian woman presented with an 18 cm by 12 cm sized, fluctuant, multi-lobulated, mobile, non-tender vulvar mass involving the mons pubis. She had undergone genital cutting and sewing during her childhood. Informed consent was obtained for surgery and the vulvar cyst was excised successfully without any significant bleeding or injury to the adjacent structures. Her postoperative course was smooth and histopathology confirmed epidermoid cyst of the vulva.ConclusionsHuge epidermoid vulvar cysts following genital mutilation are rare and presentation in a postmenopausal woman has not been reported. Practitioners in areas where female genital mutilation is prevalent should be aware of the peculiar anatomic and technical aspects of the surgical removal of these giant vulvar cysts for successful therapeutic and cosmetic outcomes.
Highlights
Epidermoid cysts of the external genitalia are one of the late complications of female genital mutilation (FGM). These cysts arise as a result of invagination/implantation of squamous epithelium under the dermis or subcutaneous tissue during the procedure of FGM which leads to the accumulation of epidermal desquamations, secretions, and other debris in a closed space [1, 2]
We have discussed the first case of a huge post-circumcision epidermoid cyst of the vulva in a postmenopausal woman who was managed surgically with successful clinical and cosmetic outcomes
Cases of large clitoral epidermoid inclusion cysts following genital mutilation have been reported in young women [5, 6], this is the first case of a vulvar cyst in a postmenopausal woman and the vulvar cyst is the biggest reported in the literature
Summary
A huge post-circumcision epidermoid cyst of the vulva is extremely rare and its presentation in a postmenopausal woman has not been reported. These vulvar epidermoid cysts might be misdiagnosed for other neoplastic vulvar disorders by inexperienced clinicians. The surgical excision of these cysts is associated with substantial perioperative complications. Female genital mutilation among Edo people: the complications and pattern of presentation in a paediatric surgery unit, Benin City. Defective sexuality and female circumcision: the cause and the possible management. Yoong WC, Shakya R, Sanders BT, et al Clitoral inclusion cyst: a complication of type 1 female genital mutilation.
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