A clitoral epidermal inclusion cyst in a postmenopausal woman: a case report

Background. Clitoral cysts are rare conditions typically observed in the paediatric population, manifesting as either benign or malign entities, and may be congenital or acquired. The most prevalent forms are epidermal inclusion cysts, often associated with trauma, particularly female genital mutilation, although their aetiology can sometimes remain unclear. This study aims to present an atypical case of a clitoral cyst occurring in an adult, post-menopausal woman, without any evident risk factor. Case presentation. A 56-year-old post-menopause patient was referred to the emergency department with a 4 cm spontaneous swelling in the clitoral area. The patient denied any history of genital trauma and reported a gradual increase in size over the past two years, accompanied by discomfort and dyspareunia. Upon clinical examination, ultrasound revealed a unilocular, hypoecho-ic, non-vascularized cystic structure. Subsequently, surgical excision was performed, and pathologic examination confirmed it as an epidermal inclusion cyst. To date, the literature reports only 14 cases of spontaneous clitoral epidermal inclusion cyst in post-puberal and adult patients, highlighting their exceedingly rare occurrence in adult women without a history of trauma. Conclusions. Despite their benign and rare nature, epidermal inclusion clitoral cysts may induce significant discomfort, potentially leading to sexual dysfunction if left untreated. Therefore, it is imperative for clini-cians to recognize them, considering the like hood of their occurrence and growth even post-menopausal women. Addressing this condition through proper counselling and prompt surgical intervention is crucial to ensure a satisfactory quality of life for affected patients.