Vulvar epidermal cyst in a 54-year-old virgin female: A very rare case report.

INTRODUCTION: Epidermal cysts are intradermal or subcutaneous tumors that can develop as a result of female genital mutilation (FGM) procedures or other traumatic events. The differential diagnosis of epidermal cysts in the vulvar or clitoral region depends on the age of presentation, with non-hormonal conditions like neurofibromatosis and nevus lipomatous cutaneous superficiality being considered in pediatric patients. CASE PRESENTATION: A 54-year-old female presented with urinary retention and a large vulvar mass. Imaging confirmed an epidermal cyst, which was surgically excised with successful resolution of the patient's symptoms and normal cosmetic appearance. DISCUSSION: Epidermoid cysts are common benign lesions that can rarely occur on the vulva, including the labia minora. These cysts may be congenital or acquired and can cause discomfort or urinary obstruction when large. Thorough clinical evaluation and imaging are crucial for accurate diagnosis and surgical planning. Excision is often recommended, especially for large, symptomatic cysts, to manage the condition and obtain a definitive diagnosis. CONCLUSION: Vulvar epidermoid cysts, though rare, can occur on the labia minora. Differentiating these from other vulvar lesions and managing large, symptomatic cysts is challenging due to limited literature. This case highlights the need for comprehensive clinical evaluation, including history, exam, and imaging, to accurately diagnose and manage these rare cysts. Surgical excision is often recommended, considering potential complications. Further documentation is needed to improve the diagnosis and management of vulvar epidermoid cysts.

Adenoid Cystic Carcinoma (ACC) of the Bartholin's gland misdiagnosed for three times: a case report.

BACKGROUND: Adenoid cystic carcinoma (ACC) in Bartholin's gland is an uncommon malignant tumor. These tumors have a vague clinical feature, so they are diagnosed late and discovered at a high-level stage. Our case presented Three Recurrences and Three times Misdiagnosis of Adenoid Cystic Carcinoma (ACC). CASE PRESENTATION: We report a case of adenoid cystic carcinoma arising in Bartholin's gland of a 64-year-old female patient that appeared after three previous vulvar tumors were excised. The patient underwent bilateral radiotherapy which was performed on the perineum. CONCLUSION: ACC of the vulvar sweat glands is prone to misdiagnosis and delay in both diagnosis and treatment. As seen in our case, it was misdiagnosed three times as Chondroid Syringoma. Further studies need to be conducted to better understand the tumor prognosis, and its optimal treatment options.

Benign multicystic peritoneal mesothelioma (BMPM) presenting with ambiguous symptoms: A rare case report.

INTRODUCTION: Benign multicystic peritoneal mesothelioma (BMPM) represents a very rare clinical entity, with only 130 registered cases in the medical literature, therefore it is usually overlooked from the list of differential diagnoses. The treatment consists of surgery and other authors suggest complementing it with hyperthermic intraperitoneal chemotherapy. PRESENTATION OF CASE: A 25-year-old multiparous female experienced periodic abdominal discomfort for two weeks. She developed constipation, urinary urgency, and irregular menstruation. Family history was remarkable for endometrial and breast cancer. Abdominal examination revealed a palpable mass. Abdominal ultrasound and computed tomography scan identified the multicystic appearance of the mass. The diagnosis was unclear, therefore exploratory laparotomy was performed, which revealed multiple grape-like clusters of cysts that were excised immediately. BMPM was diagnosed based on the pathology report. Eventually, the follow-up did not reveal any recurrence. DISCUSSION: Mesothelial tumors include three pathological entities, including Benign multicystic peritoneal mesothelioma (BMPM). BMPM is an uncommon neoplasm and has a high recurrence rate after surgery. BMPM consists of clear cysts that take the shape of a grape-like cluster. Clinically, BMPM resembles a tangible abdominal mass and it is challenging to be diagnosed, due to its numerous differential diagnoses. CONCLUSION: The definitive diagnosis of intraperitoneal cystic masses is usually challenging. Therefore, BMPM -although very rare- should always be thought of when dealing with an intraperitoneal cystic mass, especially in women in the reproductive years. In our case cytoreductive surgery solely was sufficient to achieve a disease free follow up, however, further studies regarding treatment and follow-up are required.