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Vaginal cyst

Vaginal cyst ultrasound case study

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Reporting Panel

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Vaginal Pathology

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Vaginal cyst

Vaginal cyst ultrasound case study

CASE–1

Clinical History

Patient presents with a painless or mildly painful vaginal swelling, sensation of a vaginal lump, discomfort during walking or sitting, dyspareunia, or incidental detection during gynecological examination. The patient was referred for pelvic/perineal ultrasound to characterize the vaginal cystic lesion.

Ultrasound Findings

Ultrasound examination demonstrates a well-defined, thin-walled, anechoic cystic lesion arising from the vaginal wall. The lesion shows posterior acoustic enhancement without internal septations, solid components, or mural nodules. No internal vascularity is demonstrated on color Doppler imaging. The surrounding soft tissues appear normal with no evidence of inflammatory changes or abscess formation. The uterus, cervix, and bilateral ovaries are unremarkable.

Report Line

A well-defined thin-walled anechoic cystic lesion is seen arising from the vaginal wall, measuring 2.8 × 2.1 × 2.4 cm. The lesion demonstrates posterior acoustic enhancement without internal septations, solid components, or internal vascularity. No surrounding inflammatory changes are identified. The findings are consistent with a simple vaginal cyst.

Impression

Features are consistent with a simple vaginal cyst. No suspicious solid component or evidence of infection is identified.

Key Learning Points

• Vaginal cysts are uncommon benign lesions and are often discovered incidentally.
• Common types include Gartner duct cysts, Müllerian cysts, epidermal inclusion cysts, and Bartholin gland cysts (located at the vaginal introitus).
• Ultrasound typically demonstrates a well-defined anechoic cyst with posterior acoustic enhancement.
• Absence of internal vascularity, mural nodules, or solid components favors a benign cyst.
• Large cysts may cause dyspareunia, pelvic discomfort, urinary symptoms, or vaginal fullness.
• Differential diagnoses include urethral diverticulum, Bartholin gland cyst, vaginal abscess, cystocele, rectocele, and cystic vaginal neoplasms.
• MRI may be useful when the site of origin or relationship to adjacent pelvic structures is uncertain.

Recommendation

Clinical gynecological correlation is recommended. Asymptomatic simple vaginal cysts generally require observation only. Symptomatic, enlarging, infected, or atypical cysts should undergo further evaluation with gynecological consultation, and surgical excision may be considered when clinically indicated.