Endometriosis presenting as a vaginal mass

A 43-year-old woman with an anterior vaginal wall mass was referred to gynaecology outpatient for diagnosis and management. Clinical assessment was indicative of a urethral diverticulum, however MRI and ultrasound imaging suggested a Gartner's duct cyst. Following excision of the lesion, histology revealed evidence of an endometriotic cyst. The patient had no other symptoms of endometriosis and remained asymptomatic 3 months following excision. This case highlights the widespread locations in which endometrial tissue can be found, and therefore the range of symptomatology. This in turn lends itself to diagnostic difficulty without histological confirmation.