A mass in the region of the Bartholin's gland in a woman over the age of 40 should raise suspicion of a Bartholin's gland carcinoma, although a cyst or abscess is significantly more common (Fig. 37A and B). Carcinoma becomes a significant concern if the patient is postmenopausal. Most carcinomas of the Bartholin's gland present as painless masses. Itching and bleeding may also occur (69). As carcinomas may arise from the gland or rarely from the duct, it is possible to have adenocarcinomas, squa-mous cell carcinomas, and transitional cell carcinomas. A rare variant is adenoid cystic carcinoma, with its characteristic cribriform appearance, with hyalinized material in the cystic spaces. Residual normal glandular elements may be recognized in Bartholin's carcinomas. Overlying skin is usually intact (Table 37).
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