Clitoral Epidermal Inclusion Cyst Following Type 2 Female Genital Mutilation

Epidermal inclusion cysts of the clitoris occur as a sequelae of female genital mutilation (FGM) due to implantation of epidermal components into the dermis. A slowly enlarging and painless mass on the genital region with associated discomfort is the most common presentation of clitoral cysts. Psychological distress, aesthetic concerns, and sexual dysfunction are among the top reasons that patients seek care for clitoral cysts. A 22-year-old Kenyan woman presented with history of a slowly enlarging and painless mass for 12 years that began 1 year after type 2 FGM. The patient complained of discomfort, low self-esteem, and psychological distress due to the appearance of her genital area. Examination revealed a midline, cystic mass measuring approximately 7 cm × 4 cm arising at the fusion of the labia majora that was nontender and mobile. Clinical diagnosis of clitoral cyst was made, and the patient was managed through surgical excision of the cyst as well as referral for psychological review and support. Despite the high prevalence (15%) of FGM in Kenya, there has not been a single reported case of clitoral cyst in the country, which could point to underreporting and the need for increased awareness.