Symptomatic Epidermoid Cyst Presenting as a Paravaginal Mass

Ischioanal fossa epidermoid cysts are uncommon masses of epithelial origin and are believed to be either congenital or the result of trauma. Surgical excision is preferred as opposed to incision and drainage because these masses may enlarge, recur, become infected, or undergo malignant transformation.

This report describes a case of a 62-year-old woman who presented for evaluation of vaginal and perineal discomfort and fullness. Physical examination and computed tomography scan revealed a 7.1-cm cystic mass in the left ischioanal space. Transgluteal surgical excision was performed and pathology revealed an epidermoid cyst. The patient recovered with symptomatic improvement.

This report demonstrates a rare case of ischioanal fossa epidermoid cyst. In cases of rectal masses, cystic lesions should be considered. Thorough physical examination, imaging studies, and proper surgical management of these masses can improve patient symptomatology, prevent recurrence, and also decrease the risk of malignant transformation.