Bartholin's Cyst Research Articles

Impact of an Outpatient Word Catheter Program for Bartholin cysts and abscesses: A retrospective cohort study.

To assess the impact of an Outpatient Word Catheter Program (OWCP) on outcomes in women presenting with Bartholin cysts or abscesses (BC/BAs). . This retrospective cohort study reviewed 408 women presenting with BC/BAs to our tertiary unit from 2017-2022. Analysis of medical records, with subgroup analysis of pregnant patients, and comparative analysis between pre- and post-intervention groups, was completed. Financial impact analysis using national activity-based funding pricing guidance to estimate cost was conducted. Pre-intervention, 65% (n = 34) of procedures were completed in theater, but after the introduction of OWCP, 61% (n = 213) of cases were treated in the day ward (χ2 = 67.43, P <0.001). Similarly, inpatient admissions reduced; 94.2% (n = 49) pre-intervention versus 26% (n = 92) post-intervention (χ2 = 92.25, P <0.001). The mean all patient admission duration decreased from 1.52 ± 0.89 days to 0.69 ± 0.59 days (P <0.001). The mean cost for those women attending in the pre-OWCP period was €4798, versus €2704 in the women who attended post-OWCP introduction (P < 0.001). After OWCP introduction, there were significant decreases in inpatient admissions, surgical procedures in theater, general anesthetic exposure, and duration of admission. Financial impact analysis revealed a significant cost reduction of ~€2100 per patient. Outpatient or day-care Word catheter programs are feasible, affordable and acceptable services to provide to women presenting withBC/BAs.

Surgical Treatment for Provoked Vulvodynia: A Systematic Review.

Provoked vulvodynia (PV), characterized by vulvar pain upon touch or pressure, is the leading cause of pain during sexual intercourse. It causes a significant decline in overall quality of life, including sexual dysfunction and mental distress. Surgical interventions, such as perineoplasty and vestibulectomy, are considered a last resort for PV cases unresponsive to less invasive therapies. This systematic review evaluates the efficacy of surgery for PV and suggests areas for future research. The literature search encompassed PubMed, Scopus, Web of Science, and Cochrane Library, identifying relevant peer-reviewed studies up to August 21, 2023. Out of 1102 records retrieved, 29 met the eligibility criteria. Surgery was typically considered after failed conservative treatments. In 15 of the 29 studies defining surgical success as a significant reduction in dyspareunia, success rates ranged from 52% to 93%. Six studies using validated scales for pain assessment noted a significant reduction in vulvar pain following surgery (p < .001). Two studies reported enhancements in sexual function ranging from 57% to 87%, while 3 studies found 89%-97% of women regained the ability to engage in sexual intercourse after surgery. Patient satisfaction rates ranged from 79% to 93%. Bartholin cysts occurred in up to 9% of cases, the most common complication reported. Surgery seems to be an effective and safe PV treatment option with success rates ranging from 52% to 97%, depending on the variation of outcome measures. Randomized clinical trials with established outcome measures are needed to determine the best surgical approach with minimal operative risk and optimal long-term outcomes.

Case series on the management and outcomes of Bartholin gland carcinoma

ObjectiveTo evaluate the management and outcomes of Bartholin gland cancer at a single tertiary institution. Study DesignA single institution retrospective review of 9 cases of BGC between 2004 and 2022 was conducted. Demographics, pathological characteristics, treatment, follow up and oncologic outcomes were extracted from clinical records. Data are summarised using descriptive statistics and survival probabilities are presented with Kaplan Meier graphs. ResultsTen cases of BGC were identified at our institution over a period of 18 years. Nine out of ten clinical records were available for analysis. Eight patients presented with vulval swelling and four were treated initially for Bartholin cyst or abscess. One patient had a histological diagnosis of adenoid cystic carcinoma while the remaining were squamous cell carcinomas. With the exception of stage I disease chemoradiation was the primary mode of treatment. Adverse events included skin desquamation (4/9), venous thrombo-embolism (2/9), gastro-intestinal (1/9) and neurotoxicity (1/9). Median follow up was 60 months with a 5-year recurrence free and overall survival at 76 % and 64 % respectively. ConclusionBGC may present after a long duration of symptoms and at advanced stages. Primary chemoradiation appears to be a feasible treatment option in advanced disease with the benefit of decreased morbidity.

Feasibility and Satisfaction With the Word Catheter in Treatment of Bartholin's Cyst and Abscess.

The Word catheter is a silicone device with a balloon system that may be inserted into a Bartholin's cyst or abscess in order to provide drainage and epithelization. The aim of this study was to evaluate the Word catheter as a therapy for Bartholin's cyst and abscess. Both patient and physician satisfaction, as well as the feasibility in an outpatient setting, were examined. A total of 51 women with a Bartholin's cyst or abscess were given the option of Word catheter insertion in an outpatient setting between August 2013 and March 2018. Both the patients and the consulting physicians were asked to complete two questionnaires, before, during and after treatment, with a view to evaluating the overall pain level, any discomfort symptoms and sexual activity, as well as satisfaction levels. The insertion procedure seemed to constitute a short yet quite painful procedure. In most cases, the consulting physicians and the patients were content with the results. Nevertheless, dislodgement of the catheter or abscess recurrence were common. The removal of the Word catheter seemed to be short, painless, and uncomplicated. Most patients experienced pain and discomfort after catheter placement over the first days, with the symptoms fading over time. Sexual intercourse appeared to be negatively influenced. The Word catheter was frequently well tolerated for the treatment of Bartholin's cysts and abscesses, with few non-serious side-effects, however, it did interfere with sexual health. Nonetheless, it may not be possible to make general recommendations based on this exploratory study.

Multimodality imaging of diseases of the vagina.

Pathologies of the vagina are important causes of symptoms related to the genital tract in women. They can be missed on transabdominal ultrasonography (USG), which is the baseline modality used for evaluation of gynaecological complaints. Transperineal USG and MRI are the imaging modalities of choice for evaluation of the vagina. Diseases of the vagina can be grouped depending upon the age group in which they occur. In children and young adults, congenital anomalies like longitudinal or transverse vaginal septum, imperforate hymen, vaginal aplasia or atresia, and rectovaginal fistula can be seen. Malignant tumours can rarely occur in children, rhabdomyosarcoma being the most common one. Common diseases affecting adults include benign lesions like epidermoid, Gartner duct, and Bartholin cysts, and urogenital fistulas involving the vagina. Endometriosis and other benign tumours of vagina including leiomyoma, fibroepithelial polyp, and angiomyxoma are occasionally seen. Malignant tumours can be primary, the most common one being squamous cell carcinoma, or secondary, due to direct extension from cancers involving the adjacent organs. Characteristic morphological changes occur in the vagina after radiotherapy, which can be identified on imaging. Knowledge about the imaging appearances of these diseases is crucial in guiding appropriate management.

Bartholin Duct Cyst and Nodular Hyperplasia: A Clinicopathological Study of 32 Patients.

Background: Inflammatory lesions and cysts are the most common Bartholin glands pathologic diagnoses. There have been very few reports of benign solid lesions of Bartholin glands such as nodular hyperplasia. Materials and methods: Thirty-two lesions diagnosed as Bartholin duct cyst in the gynecologic specialized institute were reviewed by two expert gynecological pathologists. Results: Using specific criteria, 7 qualified as nodular hyperplasia, 25 as Bartholin duct cyst. The average age of the patients with nodular hyperplasia was 31 years (range, 24 to 43). These lesions were solid, solid and cystic or purely cystic, had a mean maximal dimension of 3.3 cm, and were frequently thought to be Bartholin cysts on clinical examination. Four lesions were diagnosed as Bartholin duct cysts, while in the review they were considered as nodular hyperplasia. Conclusion: Nodular hyperplasia of Bartholin gland may be more common than is reported in the literature. This study showed that the diagnosis of nodular hyperplasia has been overlooked due to limited literature sources.

Retrospective analysis of vulvar benign masses: 5-year single center experience

Aim Although benign lesions in the vulva occur rarely, they are one of the reasons for women to apply to the hospital. Although the most common benign masses in the vulva are bartholin cysts; First of all, it is necessary to rule out malignancy. Our aim is to analyze the demographic and presentation characteristics, clinical and laboratory findings, and surgical operation results of women who applied to a tertiary center with a vulvar mass. Materials and methods All women who had vulvar mass in a tertiary perinatology center between January 2016 and January 2021 were retrospectively included in this study. The demographic data of the patients (age, gravida, parity, abortus numbers), complaints and comorbidities were analyzed. Clinical findings, hospitalization times, treatments and surgery results were recorded. Results Overall, 198 patients who had vulvar masses were included in this study. The median age was 35.0 years. While 15.2% of the patients were nulliparous; 51.1% (n=135) had at least one abortion history. The most common complaints were genital swelling/mass in 77.8% and pain in 36.9%. The most common diagnoses were “bartholin cyst/abscess” in 89.9% and vulvar mass in 6.6%. Cyst excision, abscess drainage and mass excision were performed in 59.6%, 30.3% and 6.6%, respectively. No morbidity or mortality was observed in any of the patients. Conclusion Bartholin's cysts/abscesses are the most common cause of benign masses of the vulva. However, in all women presenting with a vulvar mass, malignancies should be excluded and a biopsy should be obtained if necessary.

Rare Case of Vulvar Fibroid with Cystic Degeneration Mimicking Bartholin Cyst

Vulvar swelling is a common condition in the reproductive age group of women. The most common vulvar swelling is a Bartholin cyst or abscess, which is unilateral. The rarest presentation of vulvar swelling is Leiomyoma, which is like a Bartholin cyst. The common symptom of vulvar Leiomyoma is discomfort during walking, voiding, or coitus, otherwise asymptomatic. Here we present a rare case of vulvar fibroid mimicking a Bartholin cyst as the patient presented with swelling in the vulva, which was gradual in onset and associated with pain. Following which patient was investigated further and managed with surgical excision and marsupialization. Therefore, we should also rule out the rarest form of any condition. Here, we provisionally diagnosed a vulvar leiomyoma as a Bartholin cyst, which was confirmed by Histopathology of excised specimen.

(031) Bartholin Cysts Can Be Treatable Causes of Female Sexual Dysfunction: Four Year Review of Diagnosis and Treatment Principles

Abstract Introduction Bartholin glands are major vestibular androgen dependent glands that release mucus secretions during sexual arousal through a 2.5 cm duct that drains at the 5 o'clock and 7 o'clock positions of the vestibule. Bartholin's glands are innervated by a branch of the pudendal nerve; mucous secretion is activated by the efferent pelvic nerve. Unilateral or bilateral obstruction of the Bartholin's ducts may occur (e.g. from trauma, infection, surgery, or idiopathic), however as long as innervation is intact, Bartholin glands continue to produce mucus despite outlet ductal occlusion. This leads to dilation of the duct with subsequent cyst formation that can result in Bartholin cyst-associated sexual dysfunction symptoms. Objectives To review patient records of women presenting to a sexual medicine clinic over a four-year period diagnosed with and surgically treated for Bartholin cyst-associated sexual dysfunction. Methods Grayscale ultrasound was performed (see figure) using the Aixplorer and cyst dimensions were measured after visual sexual stimulation in the office. Vulvoscopy was performed with the Wallach Zoomscope. Bartholin cyst anesthesia testing was performed using benzocaine 20%, lidocaine 8% and tetracaine 6%. Marsupialization surgery was performed as an out-patient. Results We identified 11 patients (mean age 26 +/− 6 years) diagnosed with Bartholin cyst-associated sexual dysfunction between January 2019 and November. 2010 who met inclusion criteria and were surgically treated by marsupialization for unilateral (4) and bilateral (7) Bartholin cysts. Their symptoms of Bartholin cyst-associated sexual dysfunction included dryness with sexual arousal (73%), pain with sexual arousal (82%), pain with orgasm (36%), spontaneous drainage (18%), and a mass at the introitus interfering with penetration (45%). 55% had been treated previously at other facilities unsuccessfully, including cyst aspiration, Word catheter placement, and marsupialization. The mean cyst size on ultrasound was 2.9 +/− 1.5 cm. Bartholin cyst anesthesia testing was positive in all (4/4) that underwent this test. Surgical principles to encourage post-op mucin drainage through the Bartholin duct included visualization of the duct at surgery (see figure) and direct anastomosis of the duct to the inferior portion of the incision at 5 and/or 7 o’clock locations (see figure). Post-operative daily arousal was encouraged and mucin secretion through the marsupialized ducts was documented by placement of gauze in the introitus and observing the mucous (see figure). At the time of this review, with an average follow-up of 8 months, 15 of 18 (83%) cysts are still draining and 9/11 patients are somewhat better, much better and very much better with resolution of Bartholin cyst-associated sexual dysfunction symptoms. Conclusions Bartholin cysts are a sexual dysfunction that can be successfully treated. Diagnosis involves an ultrasound after sexual arousal and a positive Bartholin cyst anesthesia test. Treatment involves marsupialization with visualization and anastomosis of the Bartholin duct to the inferior portion of the incision at the 5:00 and 7:00 locations. Post-operative daily arousal is encouraged with documentation of mucinous drainage detected. Disclosure No.

(004) Using Genital Anesthesia Testing (GAT) in the Management of Bothersome Genital Dysesthesia

Abstract Introduction For women experiencing bothersome genital arousal, pain, or other dysesthesia symptoms (e.g. feelings of itching, burning, pulsating, tearing), it is important to ascertain whether symptoms are secondary to pathology in the genital area, or are referred from upstream pathology in the pelvis or perineum, cauda equina, spine, and/or brain regions. Specific understanding of the location of the trigger associated with the genital dysesthesia is critical to directing treatments for disease modification management. Objectives The aim of this study is to review the methodology of minimally-invasive genital anesthesia testing including the clitoral anesthesia test (CAT – Figures 1a, 1b), vestibular anesthesia test (VAT – Figure 2), urethral anesthesia test (UAT) and/or Bartholin cyst anesthesia test (BAT). Methods Prior to genital anesthesia testing the patient documents the symptom score intensity on a scale of 0 to 10 where 10 is most severe. It is critical that the patient have significant symptoms in the specific genital region(s) (clitoris, vestibule, urethral meatus and/or Bartholin’s cyst); the patient may need to perform some maneuvers to trigger the dysesthesia symptoms and/or reduce or discontinue medications that offer relief from the dysesthesia. The area to be tested is demarcated under vulvoscopic examination with a marking pen. Using a cotton swab as an applicator, benzocaine (20%), lidocaine (8%), tetracaine (8%), (BLT) is first applied to the inner arm to assess for allergies. Assuming there is no allergic reaction, the BLT is applied generously to the specific genital region. If needed, local subcutaneous administration of 1% lidocaine using a 30-gauge needle can supplement the anesthesia. After 10 minutes, provocative maneuvers are performed to determine whether or not there is clinically significant symptom reduction from the pre-genital anesthesia test symptom score. Results A positive genital anesthesia test is consistent with clinically significant symptom reduction from the pre-genital anesthesia test symptom score intensity. A positive genital anesthesia test implies that the local genital region (clitoris, vestibule, urethral meatus and/or Bartholin’s cyst) is the trigger of the genital dysesthesia so appropriate treatment strategies may be offered. For example, a positive CAT may require lysis of adhesions. A positive VAT may require hormone management for hormone mediated vestibulodynia, or vestibulectomy for neuro-proliferative vestibulodynia. A positive UAT may require surgical reconstruction of the urethral meatus. A positive BAT may require marsupialization. A negative genital anesthesia test is consistent with upstream pathology leading to testing of the integrity of the pudendal nerve or assessment of the cauda equina with neuro-genital testing and lumbar/sacral MRI. Conclusions Genital anesthesia testing is an excellent minimally invasive, in office diagnostic test to help localize the trigger of the genital arousal, pain, or dysesthesia in the genital region. Recognizing the location of the trigger associated with the genital dysesthesia as emanating from the genital region rather than the pelvis or perineum, cauda equina, spine, and/or brain region, will allow for disease modification and specific management strategies of the clitoris, vestibule, urethral meatus and/or Bartholin cyst. Disclosure No.

(130) Marsupialization of the Bartholin Duct Cyst and Recanalization for Symptomatic Recurrent Bartholin Cysts

Abstract Introduction Bartholin glands (BGs) are located posteriorly on each side of the vaginal introitus. During sexual arousal, BGs release mucinous secretions into the vestibule at the 5:00 and 7:00 positions via a 2.5 cm Bartholin duct (BD). The BD may become obstructed from trauma, inflammation, infection, vestibular or vulvar surgery, or idiopathic factors. Despite BD obstruction, the glands may continue to produce mucinous secretion causing cystic dilation of the duct. Thus, a Bartholin duct cyst (BC) is formed and can result in pain during sexual arousal. Treatment strategies include sitz baths, hot compresses, aspiration, Word catheter placement, or BC marsupialization. Objective This chart review was performed to assess the safety and efficacy of a new technique for BD marsupialization in patients with symptomatic BC. Methods This is a chart review of patients with symptomatic BC who underwent BD marsupialization using a new technique. This new strategy involves marsupialization of the anterior wall of the BC, identification of the BD lumen on the posterior wall of the BC under surgical Loupes magnification and advancement of the BD lumen directly to the surface of the introitus at 5:00 and/or 7:00 locations. The BD neo-ostium was secured with interrupted 4.0 chromic sutures. Results 14 patients (mean age 28 ± 9 years) between 2015 - 2022 diagnosed with recurrent BC-induced pain during sexual arousal were treated by marsupialization of the BC and advancement of the BD directly to the mucosal surface of the introitus. Each patient averaged 3 prior BC treatments (range 0- 6). Symptoms included pain with sexual arousal or walking/sitting (100%) and an introitus mass interfering with penetration (50%). The mean BC size on ultrasound was 2.7 ± 1.6 cm x 2.4 ± 1.7 cm. All BD marsupialization surgeries were performed as outpatient procedures. Sexual arousal was encouraged early post-operatively and mucinous secretion documented by vestibular photography post-arousal. With an average follow-up of 14 months, 11/14 (79%) symptomatic BCs have resolved. Conclusions A new surgical strategy is described for patients with symptomatic BCs involving BD anastomosis directly to the introital mucosa at the 5:00 or 7:00 locations, resolution of BD obstruction, and excellent restoration of BG lubrication. Disclosure No

Vulvar Leiomyoma Mimicking a Bartholin’s Gland Tumour

Bartholin's cyst is frequently the cause of unilateral vulval enlargement in a woman of reproductive age. We discuss a noteworthy occurrence of vulval leiomyoma that was initially misdiagnosed as a recurrent Bartholin's cyst in this article. Intraoperatively, it was observed that the 35-year-old lady who had been scheduled for marsupialization really had a tumour of vulvar or bartholin's gland origin rather than a cyst. It was discovered to be rather hard in consistency and well encapsulated intraoperatively. The vulvar leiomyoma was proven to be the diagnosis by histopathology. Extrauterine leiomyomas are uncommon and more challenging to diagnose. Bartholin's cysts, fibromas, lymphangiomas, soft-tissue sarcomas, and neurogenic tumours are among the differential diagnoses. Following surgery, it is advised that all patients have long-term follow-up. Keywords: Vulvovaginal leiomyoma, Vaginal wall mass, Benign tumor, Bartholin’s gland, Vulvar mass, Misdiagnosis, Excision, Enucleation, Bartholin’s 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.

Vulvar leiomyoma in an adolescent girl: a case report and review of the literature

BackgroundVulvar leiomyoma is a rare soft tissue tumor, with only around 300 cases described in the literature. Owing to its low incidence of just 0.03% of all gynecological tumors, it often poses a great diagnostic challenge, especially in teenagers. We report this rare occurrence of vulvar leiomyoma in a teenage girl who was primarily left untreated due to cultural taboos and fear of loss of virginity. The main aim in presenting such rare case studies is to raise awareness and expand the diagnostic horizon of the surgeon for appropriate management.Case presentationWe describe a case of a 15-year-old North Indian, sexually inactive unmarried girl, who presented with a history of painless swelling in the left labia majora for the last 1 year, which gradually increased in size. There was no associated pain or any other difficulty. Local examination revealed a 14 × 10 cm solid, unilateral nonpedunculated mass on the left labia majora with superficial vascularity. Differential diagnoses of sarcoma, lipoma, Bartholin cyst, and fibroid were kept in mind. Ultrasonography revealed a solid mass with superficial vascularity with normal internal genitalia. The mass was enucleated with an intact capsule under anesthesia. Histopathology confirmed it to be benign vulvar leiomyoma. The patient was discharged after 3 days in a satisfactory condition.ConclusionLeiomyoma of the vulva is an exceptionally rare tumor and is seldom seen in teenagers. It is often misinterpreted as a Bartholin cyst and should be kept as one of the differential diagnosis in teenage girls presenting with unilateral vulvar swelling. Vulvar leiomyoma can be completely cured by surgical removal if diagnosed timely without compromising virginity, so should never be missed in adolescents.

Our treatment outcomes in bartholin cysts or abscesses

The purpose of this study was to examine the outcomes of Bartholin abscess or cyst surgery, silver nitrate therapy, and cyst or abscess excision in terms of recurrence, duration of the procedure, and healing times. The files of 100 patients treated in our hospital for Bartholin cysts or abscesses between March 2022 and December 2022 were reviewed retrospectively. The patients’ demographic characteristics were recorded. Demographic data, the location and size of Bartholin abscesses, complaints at presentation, and cases with recurrence were noted. The patients were divided into three groups according to the treatment applied and were compared with one another, especially in terms of recurrence, operative time, and recovery time. Group 1 consisted of those who underwent drainage due to Bartholin cyst or abscess, Group 2 of those treated with silver nitrate, and Group 3 of those who underwent cyst excision. Recurrence was detected in 12 (40%) of the cases in Group 1. Relapsed cases were treated with silver nitrate. Recurrence was observed in only one patient in the group treated with silver nitrate (Group 2). Bartholin cyst excision was performed on that patient. Mean operation times were 2.80 min in Group 1, 4.40 min in Group 2, and 23 min in Group 3 (p=0.0001). Mean recovery times were 3.37±0.49 days in Group 1, 6.13±0.73 days in Group 2, and 13.70±2.09 days in Group 3 (p=0.0001). A comparison of the patients in all three groups revealed that the recurrence rate was higher in the group receiving abscess drainage. While recurrence was observed in only one patient in the silver nitrate group, no recurrence occurred in the cyst excision group (p&lt;0.001). This study emphasizes that silver nitrate application is a simple practical method that can be performed using local anesthesia, and involving minimal scar tissue, a faster procedure time, and faster recovery.

Editorial

Editorial

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.

Clinicopathological Spectrum of Vulvar Lesions-A Retrospective Study

Introduction: Vulvar lesions constitute a wide spectrum ranging from non neoplastic inflammatory lesions to malignancies. Some show nodular masses and others remain asymptomatic. This poses challenges to clinicians in differentiating non neoplastic inflammatory dermatoses from benign and malignant lesions. Along with the clinical history and physical examination, a biopsy of the lesion plays an important role in proper diagnosis and treatment. Aim: The aim of the present study was to identify the morphological spectrum of vulvar lesions with clinical and histological findings. Materials and Methods: This was a retrospective observational study conducted in the Konaseema region of India for two years from January 2019 to January 2021. A total of 85 female patients with vulvar lesions were included in the study. Biopsy samples were obtained from all the 85 cases and were formalin-fixed, routinely processed, and paraffin embedded. Haematoxylin and Eosin (H&amp;E) staining was done. Special stains were done wherever necessary. The results were analysed using Microsoft excel. Results: The age of patients ranged from 18 to 88 years. The most common age of patients was in the 4th decade (30 cases amounting for 35.29%). The mean age of the study population was 39.5±15 years. Among the 82 cases, 40 (48.78%) were non neoplastic lesions, and 42 (51.21%) were neoplastic lesions. Among the neoplastic category, 27 (64.2%) were benign lesions and 15 (35.71%) were malignant lesions. The non neoplastic category included five infections (12.5%) and 35 non infectious inflammatory lesions (87.5%). The infections included one case of MC and 4 cases of condyloma acuminatum. The non infectious, and non neoplastic inflammatory lesions included 10 cases of Lichen Sclerosus Atrophicus (LSA), one case of Lipomatoushamartoma, four cases of Lichen planus, six cases of epidermal cysts, 10 cases of Bartholin cysts and four cases of Gartner duct cyst. The benign lesions in the neoplastic category included four cases of Hidradenomapapilliferum, four cases of Aggressive Angiomyxoma (AA), 12 cases of Fibroepithelial Stromal Polyps (FEP), and a case of Leiomyoma. The malignant lesions included 14 cases of squamous cell carcinoma and a case of extramammary Paget’s disease. Conclusion: Vulvar lesions can be due to eclectic causes and pose a diagnostic difficulty both clinically and histopathologically due to their similar presentation. Thorough clinical and pathological examination along with proper clinicopathological correlation is required for accurate diagnosis and treatment.

Vulvovaginal Angiomyofibroblastoma: An Uncommon Benign Mesenchymal Tumour

The female genital tract angiomyofibroblastoma (AMFB) is a rare benign mesenchymal tumour that mostly affects premenopausal women. Although it is most commonly seen in the vulvovaginal region, it has also been documented in the inguinosacral region, pelvis, and retroperitoneum (1,2). Patients usually present with indolent, painless swelling in the vulvovaginal region, or a pedunculated lesion on rare occasions. Those that appeared in the vulva were frequently misdiagnosed as Bartholin cysts. Leiomyoma is a differential in the vaginal area. AMFB must be recognised from aggressive angiomyxoma (AA) due to the latter’s potential for recurrence with typical infiltrative boundaries. We discuss a case of a 46-year-old woman who had a slow-growing paravaginal swelling incidentally discovered during a total hysterectomy for leiomyoma five years prior.

Management of Bartholin's cyst and abscess

Management of Bartholin's cyst and abscess