Vaginal Dermoid Cyst: A Case Report

Vaginal dermoid cysts are exceedingly rare benign germ cell tumors, which present unique diagnostic and surgical challenges.

A 17-year-old nulligravid patient presented with acute-on-chronic pelvic pain, dyspareunia, and difficulty with tampon insertion. Imaging with transvaginal ultrasound and CT of abdomen and pelvis suggested a fat-containing pelvic mass presumed to be intraperitoneal. Two laparoscopies were performed, the second with excision of a benign corpus luteum. Subsequent pelvic exam and pelvic MRI allowed for improved localization and characterization of the mass, and transvaginal excision later confirmed a vaginal dermoid cyst. The postoperative course was complicated by vaginal hematoma requiring reoperation.

Although rare, vaginal dermoid cysts should be included in the differential diagnosis of atypical cystic pelvic masses. Accurate preoperative localization with physical exam and advanced imaging is essential to guide appropriate management and avoid unnecessary surgery.