Paraclitoral Epidermal Cysts: A Literature Systematic Review

Background and Objectives: Epidermal inclusion cysts are benign lesions with usually good prognosis. Clitoral epidermal cysts are very uncommon and can be spontaneous or caused by a prior surgical operation, usually female genital mutilation. Surgical removal of the cyst is the preferred treatment, and it is associated with excellent postoperative results. Materials and Methods: We present the medical history and surgical treatment of a 39-year-old woman with a symptomatic epidermal clitoral cyst. To discuss our case in the context of a synopsis of similar published cases, we conducted a systematic review of epidermal clitoral cysts to synthesize available knowledge on symptoms, diagnosis, etiology, and management about this rare condition. Results: A total of 46 studies, describing 162 patients, were identified. The presence of clitoral cysts should be suspected in patients complaining of vaginal bulging, sexual discomfort, and urinary symptoms. Clinical examination as well as other instrumental techniques represent a useful tool for diagnosis. The gold standard treatment is to perform surgical excision. Follow-up is needed to diagnose possible recurrences. Conclusions: We present the first systematic review focusing on epidermal clitoral cysts including both spontaneous and traumatic etiologies. It is important to include these lesions in the differential diagnosis of congenital clitoromegaly and clitoral mass, especially in the case of history of FGM, trauma, or surgery in the genital area.