Undefined Vulval Cyst Images: 14 Clinical Photos

Vulval cysts are common benign lesions that appear as dome-shaped, firm or fluctuant swellings on the vulva. This image gallery provides clinical photographs of various vulval cyst types, aiding in visual diagnosis and differential identification. Images sourced from dermatological archives demonstrate key morphological features.

What are vulval cysts?

Vulval cysts arise from blocked glands, developmental remnants, trauma, or spontaneous origins. They may be asymptomatic or cause pain, dyspareunia, or cyclic discomfort depending on size and location. Common sites include labia majora, labia minora, and perineal areas. Bartholin gland cysts, the most frequent type, form from duct obstruction at the 4 and 8 o’clock positions relative to the vaginal introitus.

These cysts contain fluid, keratin, mucus, or sebaceous material. While often incidental findings, larger or infected cysts require intervention. Prevalence peaks in reproductive years (20-50), linked to hormonal influences and glandular activity.

Types of vulval cysts

Several distinct cyst varieties occur on the vulva, each with characteristic histology and clinical presentation:

• Bartholin gland cysts/abscesses: Located posterolaterally near vaginal opening; small cysts painless, infected ones form painful abscesses with pus.
• Epidermal inclusion cysts: Firm, keratin-filled from trauma or surgery; common post-episiotomy.
• Sebaceous cysts: Blocked sebaceous glands yield greasy, yellow-white contents.
• Mucinous cysts: Mucus-filled from minor vestibular glands or developmental remnants.
• Gartner’s duct cysts: Anterolateral vaginal wall; embryonic remnants.

Bartholin gland cyst images

Bartholin cysts present as smooth, fluctuant swellings (1-4 cm) at the lower vaginal vestibule. Untreated, they may resolve spontaneously or persist asymptomatically.

• Image 1: Small, painless Bartholin cyst on right labium minus, 1 cm diameter, translucent with underlying erythema. Typical in asymptomatic cases.
• Image 2: Enlarged Bartholin cyst (3 cm) causing vulval asymmetry; patient reports discomfort during intercourse. Surface tense, non-inflamed.
• Image 3: Infected Bartholin abscess: Tender, red, fluctuant mass with central pointing. Associated fever and discharge noted.
• Image 4: Post-drainage Bartholin cyst with Word catheter in situ; prevents reclosure, promotes epithelisation.

Diagnosis confirmed by location and transillumination; ultrasound differentiates from solid tumors.

Epidermal inclusion cyst images

These keratin-packed cysts arise from invaginated epithelium, often post-trauma. Firm, white-yellow, 0.5-2 cm.

• Image 5: Epidermal inclusion cyst on labium majus; punctum visible, cheesy exudate on expression. No inflammation.
• Image 6: Multiple small inclusion cysts along episiotomy scar; history of vaginal delivery.
• Image 7: Ruptured epidermal cyst showing laminated keratin debris; secondary infection risk.

Sebaceous cyst images

Sebaceous cysts on vulvar skin from pilosebaceous unit obstruction. Greasy contents distinguish from epidermal types.

• Image 8: Sebaceous cyst labia majora; lobulated, yellow-white core. Painless unless inflamed.
• Image 9: Infected sebaceous cyst with surrounding cellulitis; red, warm, purulent discharge.

Mucinous and vestibular cyst images

Mucinous cysts from minor glands; bluish, translucent, mucus-filled.

• Image 10: Mucinous cyst inner labium minus; soft, 1.5 cm, cyclic tenderness linked to menses.
• Image 11: Multiple vestibular cysts (vestibular papillomatosis mimic); asymptomatic, micronodular.

Gartner’s duct and other cyst images

Gartner’s cysts along anterolateral vagina; rare, persistent embryonic ducts.

• Image 12: Gartner’s duct cyst protruding vaginally; clear mucoid fluid. Detected on speculum exam.
• Image 13: Skene’s gland cyst near urethra; causes dysuria if large.
• Image 14: Endometriotic cyst vulva; cyclic pain, chocolate cyst contents.

Symptoms and clinical features

Many vulval cysts are incidental; symptomatic ones cause:

• Palpable lump or swelling.
• Pain on walking, sitting, intercourse (dyspareunia).
• Infection signs: redness, warmth, fever, discharge.
• Urinary symptoms if urethral compression.

Diagnosis

Clinical exam suffices for most; biopsy if atypical. Ultrasound/MRI for deep lesions. Dermoscopy shows puncta, translucency. Exclude malignancy (rare in cysts).

Treatment

Conservative for small/asymptomatic: observation, sitz baths.

• Incision/drainage: For abscesses; catheter placement.
• Marsupialization: Recurrent Bartholin cysts.
• Excision: Symptomatic keratinous cysts.

Antibiotics if infected (e.g., cephalexin).

Frequently Asked Questions (FAQs)

Q: Do vulval cysts always need treatment?

A: No, small painless cysts often resolve spontaneously or remain asymptomatic. Treat if symptomatic or recurrent.

Q: Can vulval cysts be cancerous?

A: Rare; most benign. Biopsy suspicious lesions (ulcerated, growing).

Q: How to prevent Bartholin cysts?

A: Good hygiene, avoid trauma. No proven prevention; prompt treatment prevents abscess.

Q: Is surgery the only option for large cysts?

A: No; aspiration or sclerotherapy alternatives for select cases.

Q: When to see a doctor for a vulval lump?

A: If painful, growing, feverish, or interfering with activities.

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Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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