Bartholin Gland Cyst Research Articles

Chistul de glandă Bartholin – abordări terapeutice actuale şi prezentare de caz

Bartholin gland cysts account for 2% of all gynecologic visits per year. Although the treatments for Bartholin gland cysts seem apparently simple, recurrent cysts as well as the differential diagnosis between simple cyst, abscess or malignant pathology can complicate the management for this apparent common problem. Bartholin gland disorders, such as cysts and abscesses, can significantly impact a woman’s quality of life, necessitating effective and lasting interventions. Starting from the standard conduct of authors in Bartholin gland cyst, the article aims to review the current therapeutic techniques and to present a case report of an approach based on the excision of the gland.

Benign Vulvar Conditions: Comprehensive Overview

Benign ailments of organs surround a large spectrum of non-diseased environments that influence the genitalia of outdoor girls. These environments can cause pain, aches, and misery for the damaged objects. This review supports a concise survey of mild vulvar ailments and their dispassionate presentations, sickness, and management. Lichen sclerosis (LS) is a non-meansfinishing angering condition characterized by tingling, pain, and atrophic adjustments. Early acknowledgments and the state of affairs are sent via email to save you from never-ending confusion. Lichen planus provides accompanying mauve, polygonal papules, and erosions, and its management involves syndrome aid and immunosuppressive remedies, which are unavoidable. Vulvar dermatoses, together with touch rash and rash, frequently present with pruritus and call for identification and removal of determinants. Vulvar intraepithelial neoplasia (VIN) is characterized by pre-malignant changes in the vulvar skin. Welltimed disease and invasion are essential for the development of vulvar tumors. Bartholin gland cysts and abscesses can result in pain, lumps, seepage, and marsupialization. Vestibulodynia and vulvodynia are caused by incessant vulvar pain, making it essential to use multidisciplinary techniques for efficient management. Understanding favorable vulvar illnesses and their distinct dispassionate visages is vital for proper disease management and tailored treatment plans. This records healthcare thought providers to determine appropriate care, relieve signs, and upgrade the reputation of the boom for stirred people.

GIANT BARTHOLIN CYST CASE REPORT

Bartholin gland cysts are common masses in the vulvar region that can range from asymptomatic to large and infected, requiring treatment [1]. In this case report, we wanted to discuss a case of a large Bartholin gland cyst that presented with painful genital swelling to our clinic and its treatment. A woman in perimenopausal age presented with a large mass in the vulva, and physical examination revealed an 18x10 cm mass originating from the left labia minora. MRI confirmed the mass, and the initial diagnosis was Bartholin gland cyst. The cyst was surgically excised totally under the operating room conditions and sent for histopathological examination. Although Bartholin gland cysts can present in various sizes and clinical features, cysts of this size are rare and can be confused with malignant masses.

Vulvar Leiomyosarcoma Masquerading as a Bartholin Gland Cyst

Vulvar Leiomyosarcoma Masquerading as a Bartholin Gland Cyst

A rare case of vulvar leiomyoma masquerading as Bartholin cyst

Vulvar leiomyoma possesses a diagnostic challenge clinically due to its rarity. Usually, it is diagnosed as Bartholin cyst in clinical practice, until histopathological examination is done. Herein we report a 49-year female with a painless perineal swelling on the right side of the vulva for 5 months. Clinically, it was suspected as Bartholin gland cyst based on her anatomical location, clinical signs, and symptoms. Excision was done and histopathological study revealed a benign smooth muscle neoplasm with whorls and interlacing fascicles of spindle shaped cells without nuclear atypia. Hence diagnosed as vulvar leiomyoma histopathologically.

Giant pedunculated angiomyofibroblastoma in young

Angiomyofibroblastoma (AMF) is an uncommon benign mesenchymal tumor that primarily affects women's vulvovaginal tissue but can sporadically affect male inguinoscrotal tissue. It is a well-circumscribed lesion that typically does not become a pedunculated hanging mass and is frequently believed clinically to be a Bartholin's gland cyst. A very few cases of vulvar AMF with pedunculated mass have been reported in the literature, and all cases involve the labia majora and middle-aged women. Here, we describe a case of a 22-year-old woman who experienced pedunculated mass in vulva involving the left labia majora. The differential diagnosis for the pedunculated vulvar mass in this young woman with a labial lesion was pedunculated AMF after excluding the most frequent illnesses.

Lipoblastoma-like tumor of the vulva: A rare benign mesenchymal neoplasm mimicking myxoid liposarcoma

Abstract Introduction/Objective Lipoblastoma-like tumor of the vulva (LLTV) is a rare, benign mesenchymal neoplasm of adipocytic differentiation that typically presents as a vulvar mass in young women, clinically mimicking a Bartholin gland abnormality. The tumor is well-circumscribed and multilobulated, composed of mature adipocytes, uniloculated lipoblasts and bland spindle cells. Morphologic features often overlap with lipoblastoma, myxoid liposarcoma, and spindle cell lipoma; however, absent alterations of PLAG1 and HMGA2 distinguish it from lipoblastoma, and lack of DDIT3 gene rearrangement distinguishes it from myxoid liposarcoma. While Rb1 usually demonstrates a “mosaic” pattern of expression, no definitive evidence of a structural abnormality in 13q has been identified. Methods/Case Report A 24-year-old female presented with mild discomfort and persistent swelling of the right vulva for one year, which was initially thought to be a Bartholin gland cyst. Physical examination revealed marked asymmetry between the right and left vulva, and ultrasound examination revealed an ovoid, hypoechoic, and solid- appearing vulvar mass (4.7 x 2.5 x 1.1 cm). She subsequently underwent excision of the vulvar mass for diagnosis and treatment. Results (if a Case Study enter NA) The excision specimen showed a relatively well-circumscribed and multi-lobulated subcutaneous mass with myxoid stroma and thin fibrous septa. The tumor was composed of a mixture of bland spindle cells, uniloculated lipoblasts and mature adipocytes. No significant nuclear atypia, necrosis or mitotic activity was identified. Immunohistochemical stains showed that the tumor cells were negative for keratin cocktail, S100 protein, SMA, and Desmin. CD34 highlighted vessels within the lesion, and Rb1 showed a "mosaic" pattern of weak and negative expression. Conclusion Lipoblastoma-like tumor of the vulva (LLTV) is a rare, benign tumor that tends to occur in young women, often clinically mimicking a Bartholin gland cyst. Recognition of this rare entity with distinction from mimics including myxoid liposarcoma is essential to avoid overly aggressive treatment. Complete conservative excision is recommended.

Abscesses and cysts of Bartholin's gland - contemporary problems of active women

Introduction and purpose:
 Bartholin's glands are paired structures, playing a significant role in lubricating the vagina through the production of mucus. They are physiologically undetectable, but when their ducts are clogged, the accumulating secretion can lead to various pathologies. The most common are cysts and abscesses, the symptomatic conditions of which are the causes of nearly 2% of gynecological visits annually. Statistically, they most frequently occur in women of childbearing age, however, young age is not a rule. The aim of the study is to summarize the state of knowledge about Bartholin's gland cysts and abscesses, with an indication of the currently used therapies.
 State of knowledge:
 In some cases, the course of these pathologies can be asymptomatic, however, the rest of the patients may experience unpleasant symptoms and require treatment. During diagnostics, it is important to carefully collect an interview and conduct a physical examination, because in most cases on this basis it is possible to make an accurate diagnosis. However, in case of doubt, imaging tests can also be used. There may be times when patients with asymptomatic cysts may not require treatment. Nevertheless, choosing the right therapy is sometimes challenging for the clinician due to the potential risk of symptoms recurring.
 Conclusion:
 Although there are many different treatments available, the most commonly used appears to be marsupialization or incision and drainage with Word catheter placement. Additionally, an increasing number of articles devoted to the use of the CO2 laser can also be observed, but even it has its drawbacks. For this reason, there is still a need for further research into new methods of treatment that would ensure both good results and high comfort for the patients.

Unani Management of Recurrent Bartholin’s Gland Cyst: A Case Report

In female reproductive system, Bartholin’s glands are one of the essential organs. In 17th century, Danish anatomist, Casper Bartholin first described about Bartholin’s cyst. at the posterior introitus of vagina two pea-sized glands of Bartholin’s glands found and secret mucus to ensure vaginal and vulval lubrication. Bartholin gland abscess or cyst is a common vulval pathology affecting the females of reproductive age group. this study was conducted in the OPD of the National Ayurvedic Teaching Hospital, Colombo-08. A 31-year-old female patient came with recurrent Bartholin cyst for one year with the complaint of left labia majora swelling, pain and difficult to walk. she was given Unani treatment Roghn e khas to apply twice a day for 2 weeks intervals for 6 weeks. the main outcome measure was to observe the resolvent of swelling and pain of Bartholin’s cyst. the patent’s swelling on labia majora and pain reduced within 4 weeks of the treatment. these Unani formulae might have as stat to resolve the swelling and pain of Bartholin’s cyst as they considered to have muhalli e warm, musakkin, daf e tafoon and daf e humma action. some of these drugs have been pharmacologically proved to its medicinal propoerties, which is reported to improve the reducing swelling and pain that may be attributed to foavinoids, saponins and alakaloids.

Bartholin's gland cysts: dermoscopic clues and differential diagnosis.

Bartholin's gland cysts: dermoscopic clues and differential diagnosis.

Radio-pathological and Clinical Correlation of Aggressive Angiomyxoma: Experience of a Tertiary Care Cancer Hospital.

Background Aggressive angiomyxoma (AAM) is a rare mesenchymal tumor predominantly affecting the pelvis and perineum of females. Due to its variable clinical presentation, it is often misinterpreted and treated as other pathologies like Bartholin gland cyst, vulvar abscess, and hernia. The tumor is locally infiltrative, making its complete surgical removal difficult. Aim The aim of the study is to highlight and illustrate the imaging and pathological features of AAM. Materials and Methods After obtaining clearance from the Institutional Ethics Committee, a retrospective study was conducted on patients with histopathological diagnosis of AAM, presenting to the dedicated sarcoma clinic between 2016 and 2019. The demographic, clinical, radiological, pathological, and treatment details were obtained from the institute's database. The magnetic resonance imaging (MRI) and computed tomography images were reviewed to assess different imaging parameters. Follow-up imaging was assessed for residual or recurrent mass in the pelvis or perineum and distant metastasis. Results A total of four patients were included with an age range of 28 to 50 years. The baseline MRI of these four patients shows pelvic mass extending into the perineum, infiltrating along the surrounding fascial planes with the characteristic laminated appearance on T2-weighted image and gradual intense enhancement following contrast administration. All patients had residual disease post-surgery and were put on hormonal therapy. Conclusion AAMs are locally aggressive, rarely metastasizing mesenchymal tumor that has a specific predilection for the perineum and pelvis of females. MRI features like laminated or striated appearance, post-contrast enhancement, and finger-like infiltrating projections should raise the suspicion of the diagnosis on baseline imaging.

English

Bartholin gland cyst is the most common vulval cyst that arises from the dilated duct resulting from the obstruction of its opening. Most cysts are asymptomatic, but if not treated adequately and remain obstructed, they get infected and can result in Bartholin gland abscess. Abscess is usually present in the women of reproductive age. Patients commonly present with fever and painful progressive swelling of labia. Imaging modalities are used to diagnose the disease and it also aids to understand its extension in the complex pelvic floor region. The vulvar region is a host of various benign and malignant lesions. Vulva is a collective term for several anatomical structures: Mons pubis, labia majora and minora, vestibule, Bartholin gland and clitoris. Most common vulva cysts are the Bartholin gland cysts. In majority of the cases, these cysts are asymptomatic or are incidentally found on imaging studies. If these cysts are not properly treated, they can get infected and cause complication such as Bartholin gland abscess. 2 % of women during their lifetime develop Bartholin gland abscess or cysts.1 Pain is one of the most common indicators of infection in Bartholin cyst. Bartholin abscess starts with progressive swelling of labia majora later accompanied by fever and painful swelling of affected vulva side.2 Imaging modalities such an ultrasonography and magnetic resonance imaging aid in the diagnosis and extension of the lesion. We present a case of 55-year perimenopausal female of Bartholin gland abscesses diagnosed using imaging modalities such as ultrasound sonography (USG) and magnetic resonance imaging (MRI).

Surgical management options for Bartholin’s gland abscess

Bartholin's glands, also known as greater vestibular glands, are two mucus-secreting glands located in the posterolateral wall of the vagina opening. The function of these glands is to produce mucus that moisturizes the vestibule of vagina. When the outflow path from the gland is blocked, a cyst forms. When the abscess is formed usually it is infections with a polymicrobial background.The most common symptoms of a Bartholin's gland cyst or abscess include pain in the vulva, swelling, difficulty walking, dyspareunia, and fever.The procedure of choice in this case is surgery. The operator can choose from among many possible options, among others there is simple incision and drainage of the cyst, marsupialization, a Word catheter, silver nitrate application, alcohol sclerotherapy, excision and laser CO2 and, as a last resort, surgical removal of the gland.The aim of this study is to review the most common surgical procedures used in Bartholin's gland cyst or abscess.

Interpreting body MRI cases: classic findings in pelvic MRI.

The high contrast resolution provided by magnetic resonance imaging (MRI) compared to all other modalities allows the interpreting radiologist to make a specific diagnosis for many common and uncommon findings. In some cases, the diagnosis can be so certain that there is no differential diagnosis. In this article, we review the most classically recognized findings when interpreting MRI of the pelvis including the following: Ovaries: Simple cyst, hemorrhagic cyst, corpus luteum, dermoid, fibroma/fibrothecoma. Uterus: C-section scar, adenomyosis, endometriosis, fibroid, congenital uterine anomalies. Cervix: nabothian cyst, cervical cancer. Vagina/Vulva: Gardener's duct cyst, Bartholin's gland cyst. Urethra: skene gland cyst, urethral diverticulum. Prostate: utricle cyst, Mullerian duct cyst, benign prostatic hyperplasia, prostate cancer.

Association of Bartholin cysts and abscesses and sexually transmitted infections.

Bartholin gland cysts or abscesses account for many gynecologic visits in the emergency department (ED). Previous smaller studies have suggested a link between Bartholin cysts/abscesses and sexually transmitted infections (STIs), but few studies have involved the ED. We retrospectively identified patients aged 18years or older seen in 1 ED between January 2012 and March 2017 who had urinalysis and urine culture and/or were tested for gonorrhea, chlamydia, or trichomonas by nucleic acid amplification testing. Univariate and multivariate analyses were used to evaluate associations between Bartholin cysts/abscess and demographics, laboratory findings, and ED diagnoses. Data were collected for 75,000 ED patients; 64 patients had a diagnosis of Bartholin cyst or abscess, 40 of whom were also tested for Neisseria gonorrhoeae or Chlamydia trachomatis. Ten percent of patients with a Bartholin cyst/abscess were infected with N gonorrhoeae, compared with 3% of those without a Bartholin cyst/abscess (P=.008). The rates of C trachomatis and Trichomonas vaginalis infections were 13% and 26%, respectively, among patients with a Bartholin cyst/abscess, compared with 8% and 30%, respectively, among those without a Bartholin cyst/abscess (P>.05 for both). On regression analysis, only increased urobilinogen level (β, 0.31; odds ratio, 1.36; 95% CI, 1.11-1.66; P=.003) and infection with N gonorrhoeae (β, 1.69; odds ratio, 5.40; 95% CI, 1.43-20.35; P=.01) were associated with a Bartholin cyst/abscess. Clinicians in the ED should consider testing patients with a Bartholin cyst/abscess for gonorrhea.

Bartholin Gland Cyst Educational Simulation Improves Knowledge and Confidence

PROBLEM: Our institution had an increasing number of ER consults for recurrent Bartholin gland cysts/abscesses between May of 2015 and June of 2016. The majority had incorrect placement of the incision and drainage site or limited or improper Word catheter use. Ob/Gyn, Family Medicine, and ER departments did not have specific training available for this diagnosis and treatment. INTERVENTION: We developed a simulation-based curriculum including a didactic presentation on Bartholin gland cyst/abscess diagnosis and treatment options, an instructional video demonstrating the steps of Bartholin gland cyst/abscess drainage with Word catheter placement, and supervised practice on an established Bartholin gland cyst model with feedback. Learner knowledge and confidence were assessed before and after the curriculum, and satisfaction with the simulation model for both I&D and Word catheter placement were assessed after the curriculum. CONTEXT: UTMCK has residencies for Ob/Gyn and Family Medicine with protected education time. There is an ER fellowship but most ER providers are ER physicians and PA’s with limited time for group learning. OUTCOME/LESSONS LEARNED: Implementation with 26 Ob/Gyn residents and 5 medical students showed increases in learner confidence and some aspects of knowledge. Participants were highly satisfied with the simulation model. Curriculum delivery will need to be tailored to the different specialties. Family Medicine residents are scheduled to complete the group training in January 2019 but the ER providers have requested to complete the training as self-study modules due to shift restrictions.

Leiomyosarcoma: A Rare Tumor of the Vulva

Abstract Objective Primary sarcomas of the vulva are very rare malignancies, accounting for 1% to 3% of all gynecologic sarcomas. Leiomyosarcoma is the most common histologic type. They present with nonspecific symptoms, aggressive behavior, and high metastatic potential. Methods A 63-year-old female patient presented with a 6-month history of a slow-growing, painless vulvar mass at the right posterior fourchette. CT scan revealed an asymmetric, heterogeneous vulvar mass extending to the distal vagina, without lymphadenopathy or evidence of distant metastasis. Focal prominence of the uterus suggestive of leiomyoma was also noted, but primary uterine neoplasm with vulvar metastasis could not be excluded. The patient underwent wide local excision of the vulvar mass with hysterectomy and bilateral salpingo-oophorectomy. Results Gross examination of the vulvar specimen showed an ulcerated 2.1-cm solid white mass with irregular borders. Microscopically, the vulvar tumor consisted of a focally infiltrative spindle and pleomorphic neoplastic proliferation with interlacing fascicular pattern and increased mitotic activity up to 25/10 HPF, without necrosis or lymphovascular invasion. The tumor focally extended to resection margins. Immunohistochemically, the neoplastic cells were positive for SMA, ER, and desmin and negative for S-100 and cytokeratin AE1/AE3. These findings, in conjunction with the clinical presentation, were consistent with high-grade primary vulvar leiomyosarcoma. Radiation therapy was subsequently started. Conclusion Primary vulvar leiomyosarcomas are rare and secondary involvement by uterine primary should always be ruled out. In addition, these tumors can be mistaken clinically as benign processes such as Bartholin gland cysts, infectious granuloma, fibroma, or myoma. Hence, it is vital to consider vulvar sarcomas in the differential diagnosis of nonspecific vulvar lesions in order to avoid delay in diagnosis and treatment. The rarity of this diagnosis makes this case worth reporting.

Intralymphatic Rosai-Dorfman Disease Associated With Vulvar Lymphedema: A Case Report of an Extremely Rare Phenomenon

Sinus histiocytosis with massive lymphadenopathy, also known as Rosai-Dorfman disease (RDD), is a self-limited histiocytic disorder of unclear etiology which most commonly presents with cervical lymphadenopathy. Purely extranodal presentation of RDD is uncommon, and isolated intralymphatic/intravascular confinement of this entity has not previously been described. We report a 16-yr-old female who presented with vaginal swelling and mass-like enlargement of the right labia. The mass had been present for nearly a year without pain or tenderness. Clinically, the lesion was thought to be a Bartholin gland cyst. Following surgical resection, histologic examination demonstrated a hypocellular myxedematous stroma with a mixture of ectatic thin and thick-walled vessels within which there were numerous collections of histiocytes, lymphocytes, and plasma cells. The histopathologic differential diagnosis included localized vulvar lymphedema, a specialized genital tract neoplasm, and childhood asymmetric labium majus enlargement. The histiocytes showed occasional plasma cells and lymphocytes within their cytoplasm, consistent with emperipolesis. Immunohistochemical studies showed that the histiocytes expressed CD163 and S100, while ERG and D2-40 highlighted their intralymphatic confinement, ultimately leading to the diagnosis of intralymphatic RDD. Intralymphatic RDD may present as vulvar lymphedema and can potentially mimic other myxedematous neoplasms of the vulvovaginal region.

Primary pseudomyogenic hemangioendothelioma of the vulva: a rare location for a rare entity

BackgroundPseudomyogenic hemangioendothelioma (PMHE) is a recently described vascular neoplasm which typically occurs in the lower extremities of young to middle-aged adults.Case presentationWe present here a unique case of PMHE arising primarily in the vulva of a 51-year-old woman who presented with a painful vulvar nodule. Clinically, it was thought as Bartholin gland cyst, vulvar hematoma or papilloma. On surgery, two nodules were found with one located in the superficial dermis and the other in the deep subcutis. Histologically, these two nodules showed similar features, composed of fascicles or sheets of plump spindled to epithelioid cells with eosinophilic cytoplasm. Given the morphological resemblance to a myogenic tumor, the lesion was initially diagnosed as a rhabdomyosarcoma by the referring pathologist. However, a comprehensive reevaluation of the submitted slides made us reconsider a PMHE, which was subsequently confirmed by immunohistochemical study.ConclusionThis case demonstrates that PMHE can also develop in the female external genitalia albeit extremely rare. This disease should be included in the differential diagnostic list of vulvar tumors with spindled to epithelioid morphology and cytokeratin-positive immunophenotypes.

Surgical management of Bartholin cysts and abscesses in French university hospitals

Objectives: To assess the methods used to manage Bartholin gland abscesses and cysts in French university hospitals.Method: Data for this descriptive, cross-sectional study with self-reported data were collected between January and March 2018 by an online questionnaire. The 11 items of the questionnaire assessed the surgical techniques known and used, the type of hospitalization, and the non-surgical management to treat Bartholin gland abscesses and cysts.Results: Overall, 116 obstetrics-gynecology residents responded to the online questionnaire. The three best-known techniques were incision and drainage, marsupialization, and excision of the Bartholin gland. Only 3% of the physicians knew about other techniques. Most participants reported that their unit treated 2–6 Bartholin gland abscesses monthly and fewer than 2 cysts. The most frequent treatment for abscess was incision-drainage (87%), followed by marsupialization (13%). The most widely used treatment for the cysts was gland excision (68.5%) followed by marsupialization (22.5%). In both cases, management generally took place on an outpatient basis (92.9%).Conclusion: This study showed that 87% of the respondents used incision-drainage for Bartholin gland abscesses, although the recurrence and complication rates of this technique have never been evaluated.