May 29th, 2022

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Gigantic Left Bartholin’s Cyst Mimicking Huge Vulvar Tumor: A Case Report
Authors:  Habibah Abdul Hamid, M.D., Reanugah Thyagarajan, M.B.B.S., Victor Chin, M.B.B.S., Ngan Kah Wai, M.D., and Amilia Afzan Mohd Jamil, M.B.B.S.
BACKGROUND: Bartholin’s gland cyst or abscess is the most prevalent cause of vulvar swelling in reproductive-age women globally. It is relatively small, <5 cm.

CASE: A 42-year-old Malay woman, para 7, with no significant medical illness or other comorbidities presented with complaints of painless swelling and itchiness over her left labia majora. She noticed the swelling 5 years prior. Initially it was the size of a pea but gradually grew to the size of a tennis ball. She was struggling to walk due to the huge mass. She denied having any clinical manifestations of infective causes, and there were no constitutional symptoms. Examination revealed an enormous solitary lobulated swelling arising from the left labia majora obscuring the whole vaginal introitus. The swelling extended from the lower part of the mons pubis near the clitoral hood to the posterior fourchette that reached to a size of 20 cm. It was successfully treated with complete surgical excision and reconstruction of the labial majora with prophylactic antibiotics. Histopathological examination confirmed it to be Bartholin’s gland cyst. No recurrence was identified on subsequent follow-up.

CONCLUSION: This unusual presentation of an abscess arising from the Bartholin’s gland can develop into a huge mass called gigantic Bartholin’s cyst that can be missed and can mimic a vulvar tumor. Clinical suspicion and anticipation of malignancy rely on the risk factors and are crucial in optimizing management strategies to improve the clinical outcome.
Keywords:  abscess, Bartholin’s gland, cysts, excision biopsy, labial swelling, vulva tumor, vulvar neoplasms
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