Müllerian Cyst of the Clitoral Hood: A Rare Vulvar Cystic Lesion-A Case Report.

INTRODUCTION: Müllerian cysts are benign embryologic lesions arising from remnants of the paramesonephric (Müllerian) ducts. They are commonly found in the vagina or cervix, whereas vulvar involvement is rare. Occurrence in the clitoral hood is exceptionally uncommon, and diagnostic differentiation from other vulvar cystic lesions is challenging. CASE PRESENTATION: A 43-year-old woman (P1A1) presented with a slowly enlarging mass in the clitoral hood over 13 years, which become mildly tender in the week prior to presentation. Physical examination showed a well-defined cystic mass (6 × 2 × 2 cm) without inflammation. Complete surgical excision was performed with preservation of clitoral neurovascular structures. Histopathology revealed a cyst lined by ciliated cuboidal to columnar epithelium, consistent with a Müllerian cyst. No malignancy was identified. Additional immunohistopathology studies were not performed due to the classic histomorphology. The patient recovered with no sensory disturbance or recurrence at the 2-week and 1-month follow-up visits. DISCUSSION: Müllerian cysts of the clitoral hood are rare and may mimic other vulvar cystic lesions. Definitive diagnosis relies on histopathological identification of ciliated Müllerian-type epithelium. The prolonged indolent growth observed in this case supports the benign nature of the lesion, whereas the anatomical proximity to clitoral neurovascular structures highlights the importance of meticulous surgical excision to preserve sensory and sexual function. CONCLUSION: A Müllerian cyst of the clitoral hood is uncommon. Histopathological evaluation is essential for definitive diagnosis. Comprehensive surgical excision with careful neurovascular preservation yields excellent outcomes.