Vaginal Dermoid Cyst

(a case report)eport
Dr Richa Sharma,Dr Kamini Rao
BACC,Bangalore
INTRODUCTION

• Vaginal dermoid cyst is a

rare condition

• We report a case of vaginal

dermoid cyst and the
surgical procedure in its
management
 CASE REPORT:

A 32 year old parous women

presented in Dr kamini rao
hospital with complaints of non
consummation of marriage with
dyspareunia with something felt
in vagina.
 CLINICAL HISTORY
• No history of any local trauma ruling out
inclusion cyst.Earlier also she had on
local examination tight introitus but no
swelling felt.
• Had twin pregnancy by LSCS.But she
observed increase in size of cystic
swelling after delivery and so presented
an year later with the same complaints.
•  
 DIAGNOSIS
• On local examination,a bulge in right
lateral vaginal wall 7x6x6 cm cystic
structure, non tender,restricted mobility
• Pelvirectal exam- 7 X 6cm mass filling
the rectovaginal septum to right
 INVESTIGATIONS
• She was investigated and TVS done which
showed cystic structure limited to paravaginal
space with no extension with echogenicity with
size of 7x6.6x6 cm with volume of 150ml.
Vaginal dermoid cyst in TVS
 MANAGEMENT
• Planned for vaginal cyst excision after all
preoperative workup.
• Extrusion of cheesy thick material with
matted hairs from it which was too thick
to aspirate.
 Clinical specimen
cyst

• Gross examination- specimen consist of

cut open cystic mass 5x5 cm
• Cut surface shows- hairs and keratin
flakes
• HPE report of cyst wall showed- cyst
wall lined by stratified squamous
epithelium with laminated keratin with
embedded hair shafts. Underlying stroma
shows sebaceous glands.Focal areas of
multinucleated giant cells and
histiocytes. 
• Impression: suggestive of dermoid
cyst(vaginal cyst)
 OVERVIEW
• A vaginal cyst is a closed sac on or under
the vaginal lining that contains fluid or
semisolid material.
 SYMPTOMS

• Asymptomatic
• Soft lump felt in the
vaginal wall or protruding
from the vagina
• Discomfort during sexual
intercourse or difficulty
inserting tampons
 CAUSES
• Vaginal inclusion cyst(MC)
• Gartner's duct cysts
• Benign tumors of the vagina-uncommon
& are usually made up of cysts.
 DISCUSSION
• A dermoid cyst ( Benign cystic teratoma)
is a benign germ cell tumor that contains
well-differentiated derivatives of all three
germ cell layers.
• Ovaries are the commonest site for this
tumor
• A dermoid cyst has also been reported
from other parts of the human body
other than the ovaries, with rare
occurrence
• It can be any where in the
gastrointestinal tract from the floor of the
mouth to the colon
• Vaginal dermoid is a rare condition. Only
five cases have been reported in
literature.

• First observed in 1899 by Stokes , who

reported a 44 year old woman who had a
1 centimeter cyst removed from just
within the hymen
• Preoperative diagnosis of the exact
nature of a vaginal cyst can be difficult
• S.S. N. SIU et al reported the
sonographic characteristics of a vaginal
cyst, which was consistent with a
dermoid cyst and was confirmed by
histopathological exam after surgical
excision of the cyst
• Transvaginal excision of this type of cyst
appears to be an appropriate surgical
treatment option which was in
conformity with some of the previous
cases
 Conclusion

• Vaginal dermoid cyst is a rare condition,

which can be diagnosed with ultrasound.
Transvaginal excision appears to be an
appropriate surgical treatment option.
 References
• 1. Curtis AH. Transactions of Societies. Chicago Gyneco-logical Society. Surg Gynecol Obstet
1913; 16: 715.
•  
• 2. Fernandez-Cebrian JM, Carda P, Morales V, Galindo J. Dermoid cyst of the pancreas: a
rare cystic neoplasm. Hepatogastroenterology 1998; 45: 1874-1876.

• 3. Fujita K, Akiyama N, Ishizaki M, Tanaka S, Ohsawa K, Sugiyama H, et al. Dermoid cyst of

the colon. Dig Surg 2001; 18: 335-337.
•  
• 4. Hirose R, Imai A, Kondo H, Itoh K, Tamaya T. A der-moid cyst of the paravaginal space.
Arch Gynecol Ob-stet 1991; 249: 39-41.

• 5. Johnston HW. A dermoid cyst of the vagina compli-cated by pregnancy. Can Med Assoc J
1939; 41: 386.
•  
• 6. Longo F, Maremonti P, Mangone GM, De Maria G, Califano L. Midline (dermoid) cysts of
the floor of the mouth: report of 16 cases and review of surgical tech-niques. Plast Reconstr
Surg 2003; 112: 1560-1565.
THANK
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