Satoshi Akaishi, Hiroaki Kuwahara
Mucous cysts of the vulva most commonly arise from the vaginal vestibule and the inner surface of the labia minora, and to our knowledge, only a single previous case arising within the clitoris has been described. We report the case of a 50-year-old multiparous woman who presented with a two-year history of asymptomatic progressive enlargement of the clitoris to 21 mm × 15 mm × 15 mm. Surgical excision under general anesthesia revealed a well-demarcated cyst containing yellow-white viscous mucoid fluid within the clitoral tissue. A compressed but morphologically intact clitoral glans was preserved, and clitoroplasty was completed using absorbable sutures. Histopathological examination revealed a unilocular cyst lined with a single layer of tall columnar epithelial cells with basally oriented nuclei and intraluminal amorphous mucoid material consistent with a mucous cyst. Differential diagnoses, including epidermal cysts, Bartholin duct cysts, mesothelial cysts, Gartner's duct cysts, and Skene's duct cysts, were excluded on clinical and histopathological grounds. No recurrence was observed at the one-year follow-up. To our knowledge, this represents the second documented mucous cyst arising within the clitoris. Complete surgical excision with preservation of the clitoral glans was accomplished with satisfactory cosmetic results.