Gigantic clitoridal cyst: a rare presentation

Abstract

Epidermal inclusion cyst of the clitoris is a rare, benign lesion that is formed when surface epithelial cells become trapped beneath the skin in the clitoral area. It is usually acquired, and commonly after female genital mutilation. This case highlights the presentation, diagnosis and its surgical management. We report a 25-year-old patient with a vulvar swelling of 9 years duration. There was a positive history of female genital mutilation in childhood. She presented on self-referral to the gynaecology clinic for evaluation, diagnosis and treatment. Preoperative assessment was done with physical examination and investigations. Following surgical enucleation, the histological assessment of the excised tissue revealed a cystic lesion lined by stratified squamous epithelium with a granular layer. The cyst contained keratin flakes. A histologic diagnosis of epidermal inclusion cyst/ clitoridal cyst was made. Clitoridal cyst usually follows female genital circumcision. It is a rarity in this part of the world as female genital mutilation is widely condemned. A high incidence of suspicious and a thorough history and physical examination is needed to make a clinical diagnosis. However, histopathological assessment remains the cornerstone for its diagnosis. Its treatment is by complete enucleation to avoid a reoccurrence.