[Vulvar mass in neonatal period : spot the difference]

Area of Science:

• Pediatric Surgery
• Neonatal Medicine
• Gynecology

Background:

• Interlabial masses in neonates are rare but require prompt diagnosis.
• Antenatal scans and initial clinical examinations may not reveal specific abnormalities.

Observation:

• Two cases of female newborns presenting with an interlabial mass on the first day of life were observed.
• Despite normal antenatal scans and delivery room examinations, distinct pathologies were identified.

Findings:

• The first case involved a paraurethral cyst causing vaginal introitus bulging, which is uncommon in infants and typically resolves spontaneously.
• The second case presented an imperforate hymen, the most common congenital female genital tract malformation, leading to potential hydrocolpos and hydrometrocolpos.

Implications:

• Accurate clinical diagnosis, supported by ultrasound, is crucial for differentiating these conditions.
• Paraurethral cysts often require conservative management, while imperforate hymen usually necessitates surgical intervention.