A large clitoral epidermal dermoid cyst: A rare long term complication after female circumcision (2015)
This study is a Descriptive research regarding II FGM/C with the following characteristics:
Author(s): Ahmed Samy El-agwany
FGM/C Type(s): II
Health area of focus: Gynaecological,urinary.
Objective: To describe a clitoral epidermal inclusion dermoid cyst in a 40-year-old female where excision of the mass was done
Study Population: A case of a 40-year-old female with complains of vulvar swelling causing dragging pain on standing and walking
Findings: A 40-year-old female with complains of vulvar swelling causing dragging pain on standing and walking was referred to the hospital. Also,it causes dyspareunia and splashing of urine stream on micturition with dysuria. She noticed this swelling first time 5 years prior to presentation as a tiny painless swelling,gradually increasing in size to occlude the introitus. However she was able to pass urine and had normal menstrual flow but with pain and splashing. She was circumcised at age of 8 years under anaesthesia by a general practitioner in a district private clinic. She had three living children,who were delivered by normal vaginal delivery. The last delivery was since 10 years. Examination revealed a Pulse rate of 85 beats per minute,blood pressure of 110/70 mmHg. The other systems were normal. Genital examination revealed an anterior midline cystic mass at site of the circumcision scar and occluding the introitus,measured about 15 • 7 cm,no discoloration of the overlying skin,non-tender,no warm ,soft in consistency,fluctuant but did not trans-illuminate light and it was not reducible. Urethral orifice was present and there was normal vagina. Investigations were done including an ultrasound of the mass which revealed a non-septate,echo rich cystic mass,measuring about 15 • 7 cm in size. Urine analysis and CBC were normal. All laboratory investigations were normal. Under anaesthesia and in lithotomy position,an elliptical longitudinal incision was done,and the mass was excised by blunt and sharp dissection and use of diathermy. It was a well-encapsulated cystic mass containing turbid fluid measuring 15 • 7 cm. Redundant skin was trimmed and the cavity was obliterated. Reconstruction of the vulva was done using vicryl 3–0 with subcuticular closure of skin. Postoperative recovery was uneventful. Study concludes that implantation dermoid cyst though a recognized complication of female circumcision is rare and a high index of suspicion is required any time a female presents with a swelling in the vulva
Geographical coverage
Region(s):Northern Africa
Country(ies):Egypt