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Large inclusion cyst following vaginal hysterectomy causing pain and mass effect requiring laparoscopic excision
IUGA Academy. Harrington P. Jun 30, 2018; 213060
Dr. Patrick Harrington
Dr. Patrick Harrington

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301

Large inclusion cyst following vaginal hysterectomy causing pain and mass effect requiring laparoscopic excision

Harrington, P1

1: Ballarat Health Services

Introduction: Vaginal cysts occur in less than 1% of the female population and are most prevalent in women in the third or fourth decade of life. A number of vaginal cysts that have been identified including, squamous epithelial inclusion cysts of the vagina, Gartner duct cysts, urothelial cysts, Bartholin gland cysts and the Mullerian or paramesonephric type. Mullerian cysts are the most common type of vaginal cyst (40%) and are usually small, benign fluid filled vaginal growths that are asymptomatic and rarely cause discomfort.

Methods: I present the case of a 58 year old woman who required two laparoscopies for pelvic pain and bleeding in the eight years after a vaginal hysterectomy. Her pain was initially attributed to ovarian cysts but only truly improved following removal of a large Mullerian cyst which was causing a mass effect.

Results: The most common location of a Mullerian cyst is on the anterolateral aspect of the vagina and they are lined by columnar endocervical and tubo-endometrial type cells resembling lining of the endo cervix and fallopian tube. Mullerian cysts are known to be caused by displacement of epithelium, secondary to trauma (i.e. surgery) or abnormal congenital distribution. There have been case reports in the literature of malignant transformation.


Conclusions: I discuss the clinical manifestations, appropriate diagnostic tools and management of this condition.

References:

1.WHO Classification of Tumours, Volume 6 IARC WHO Classification of Tumours, No 6 Kurman, R.J., Carcangiu, M.L., Herrington, C.S., Young, R.H.

2.Benign Cystic Lesions of the Vagina: A Literature Review, EILBER, KARYN SCHLUNT et al. The Journal of Urology , Volume 170 , Issue 3 , 717 - 722

Disclosure:

Work supported by industry: no.

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