Epidermal Inclusion Cyst Vulva

Bartholins Cyst
Figure 1 Bartholin's cyst. (A) A large swelling is noted on the left. (B) The cyst wall is lined by transitional epithelium, consistent with Bartholin's duct.
Vulval Vestibule
Figure 2 Epidermal inclusion cysts. (A) Multiple firm tan nodules are seen. (B) The cyst is lined by stratified squamous epithelium. The cyst contents are composed of keratinaceous debris.

Table 1 Bartholin's Cyst and Abscess


Diagnosis Symptoms appearance

Bartholin's Cystic mass at duct cyst/ the 4 or 8 abscess o'clock position of the introitus. Painful if inflamed

Differential diagnosis Therapy

Surgical, including Word catheter placement for abscesses, marsupiali-zation of cysts, or occasionally gland excision, usually in older women

Cystic mass. Epidermal inclusion May be up cyst, mucinous cyst to 8 cm or of vestibule, more hidradenoma papilliferum, lipoma, cystic lesions of vagina

Table 2 Epidermal Inclusion Cyst



Clinical appearance

Differential diagnosis


Epidermal inclusion cyst

Cosmetic issue. May rupture and drain foul smelling contents

Single or multiple dome-shaped nodules with smooth external surface

Usually not a diagnostic challenge

None, excision, or evacuation origin and origin from the urogenital sinus, metaplasia, or heterotopia. They may be seen in the vestibule, or in the superior aspect of the labia minora in multiparous women. Mucinous cysts are lined by a single layer of mucinous columnar epithelium. Pure ciliated cysts lined by ciliated columnar epithelium are rare; however, ciliated cells are often present in predominantly mucinous cysts. Papillary infoldings of the mucosa is commonly seen in these cysts (Table 3).

Vulval Vestibule
Figure 3 (A) (See color insert) Mucinous cyst of the vestibule. (B) Mucinous cyst of the vestibule: the cyst is lined by a single layer of mucinous columnar epithelium. (C) Mucinous and ciliated cyst: the cyst is lined by a combination of mucinous and ciliated columnar epithelium.
Table 3 Mucinous and Ciliated Cysts









Discomfort or pain

Cyst, usually of

Epidermal inclusion


or ciliated

because of location,

vestibule or

cyst, Bartholin's duct



or asymptomatic

labia minora

cyst, and vaginal cysts

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