Final Aicog

8/8/2019 Final Aicog

1/23

Dr Richa Sharma,Dr Kamini Rao

BACC,Bangalore

Vaginal Dermoid Cyst

(a case report)eport


2/23

INTRODUCTION

Vaginal dermoid cyst is a

rare condition

We report a case of vaginal

dermoid cyst and the

surgical procedure in itsmanagement


3/23

CASE REPORT:

A 32 year old parous womenpresented in Dr kamini raohospital with complaints of non

consummation of marriage withdyspareunia with something feltin vagina.


4/23

CLINICAL HISTORY

No history of any local trauma ruling outinclusion 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.


5/23

DIAG

NOS

IS

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


6/23

INVES

TIGA

TION

S 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.


7/23


8/23

MAN

AGEM

ENT

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.


9/23

Clinical specimen

cyst

Gross examination- specimen consist of

cut open cystic mass 5x5 cm

Cut surface shows- hairs and keratinflakes


10/23

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 andhistiocytes.

Impression: suggestive of dermoid

cyst(vaginal cyst)


11/23

OVERVIEW

A vaginal cyst is a closed sac on or

under the vaginal lining that

contains fluid or semisolid material.


12/23

SYMPTOMS

Asymptomatic

Soft lump felt in the

vaginal wall or protruding

from the vagina

Discomfort during sexual

intercourse or difficulty

inserting tampons


13/23

CAUSES Vaginal inclusion cyst(MC)

Gartner's duct cysts

Benign tumors of the vagina-uncommon

& are usually made up of cysts.


14/23

DISCUSS

ION

A dermoid cyst ( Benign cystic teratoma)

is a benign germ cell tumor that contains

well-differentiated derivatives of all three

germ cell layers.


15/23

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


16/23

It can be any where in the

gastrointestinal tract from the floor of the

mouth to the colon


17/23

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


18/23

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 byhistopathological exam after surgical

excision of the cyst


19/23

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


20/23

Conclusion

Vaginal dermoid cyst is a rare condition,

which can be diagnosed with ultrasound.

Transvaginal excision appears to be an

appropriate surgical treatment option.


21/23

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, IshizakiM, 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. CanMed Assoc J

1939; 41: 386.

6. Longo F,Maremonti P,Mangone GM, DeMaria 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.


22/23


23/23

THANK

YOU

Final Aicog

Documents

Transcript of Final Aicog