Endometriosis in the Bartholin Gland: A Case Report

Hakimi, Ihssane

doi:10.11648/j.jgo.20140205.12

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…While 263 patients (95.3%) had undergone previous episiotomy, obstetrical lacerations, whether repaired or not, perineal trauma or vaginal surgery or injury, only 13 patients (4.6%) developed spontaneous vulvo-vaginal endometriosis i.e., in the absence of the most frequently associated conditions (Table 3). Among the latter, lesions developed in the Bartholin gland in 6 cases (21,44,48,62,70,80). Previous history wasn't described for seven patients (40,45,47,74).…”

Section: Resultsmentioning

confidence: 99%

Diagnosis and Treatment of Vulvo-Perineal Endometriosis: A Systematic Review

et al. 2021

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Objective: To describe the available knowledge on vulvo-perineal endometriosis including its diagnosis, clinical management and recurrence rate.Methods: We followed the PRISMA guidelines for Systematic Reviews and our study was prospectively registered with PROSPERO (CRD42020202441). The terms “Endometriosis” and “Perineum” or “Vulva” were used as keywords. Cochrane Library, Medline/Pubmed, Embase and Clinicaltrials.gov were searched. Papers in English, Spanish, Portuguese, French or Italian from inception to July 30, 2020 were considered. Reference lists of included articles and other literature source such as Google Scholar were also manually scrutinized in order to identify other relevant studies. Two independent reviewers screened potentially eligible studies according to inclusion criteria.Results: Out of 539 reports, 90 studies were eligible including a total of 283 patients. Their mean age was 32.7 ± 7.6 years. Two hundred sixty-three (95.3%) presenting with vulvo-perineal endometriosis have undergone either episiotomy, perineal trauma or vaginal injury or surgery. Only 13 patients (4.7%) developed vulvo-vaginal endometriosis spontaneously i.e., without any apparent condition favoring it. The reasons that motivated the patients to take medical advice were vulvo-perineal cyclical pain increasing during menstruations (98.2% of the patients, n = 278). Out of the 281 patients for whom a clinical examination was described, 274 patients (97.5%) showed a vulvo-perineal nodule, mass or swelling while six presented with bluish cutaneous lesions (2.1%) and 1 with bilateral polyps of the labia minora (0.4%). All but one patients underwent surgical excision of their lesions but only 88 patients (28.1%) received additional hormonal therapy. The recurrence rate was 10.2% (29 patients) considering a median follow-up period of 10 months (based on 61 studies).Conclusion: In conclusion, vulvo-perineal endometriosis is a rare entity with approximately 300 cases reported in the literature since 1923. With the available knowledge shown in this systematic review, we encourage all practitioners to think about perineal endometriosis in case of perineal cyclical pain with or without previous perineal damage. Diagnosis should be done with clinical exam, perineal ultrasound and pelvic MRI when available. In case of anal sphincter involvement, perianal ultrasound should be performed. Surgical excision of the lesion should be realized in order to remove the lesion and to confirm the diagnosis histologically. Hormonal treatment could be proposed to attempt to decrease the size of a large lesion before surgery or to avoid recurrence of the lesion. As evidence-based approach to the diagnosis, treatment and recurrence rate of affected patients remains a challenge given its low prevalence, the variations in management found in the articles included and the limited quality of available studies, we suggest that a prospective database on vulvo-perineal endometriosis should be generated to increase knowledge but also awareness among healthcare professionals and optimize patients' care.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier: CRD42020202441.

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Section: Resultsmentioning

confidence: 99%

Diagnosis and Treatment of Vulvo-Perineal Endometriosis: A Systematic Review

et al. 2021

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“…In most cases, patients presented with cyclical vulvar pain, and were initially thought to have a Bartholin gland cyst. In three reported cases, during marsupialization of what was thought to be a Bartholin cyst, chocolate colored fluid drained from the mass, and the diagnosis was confirmed by pathology [3,6,8]. In all reported cases, surgical excision was the management of choice.…”

Section: Discussionmentioning

confidence: 92%

“…In all reported cases, surgical excision was the management of choice. In one report, the patient received six months of treatment with a luteinizing hormone releasing hormone analogue with a good evolution [8]. As there are few such cases reported in literature, there is no good data to comment on complication or recurrence rates.…”

Section: Discussionmentioning

confidence: 99%

A unique case of isolated vulvar endometriosis

Ali

Musselman

Smithgall

et al. 2022

J Case Rep Images Obstet Gynecol

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“…Endometriosis in the Bartholin gland without surgery in the perineal area is a rare presentation of extraperitoneal endometriosis. So far, only five cases [1][2][3][4][5] concerning endometriosis in the Bartholin gland have been reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

Endometriosis of the Bartholin gland: a case report and review of the literature

2020

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Background: In this case report we present a case of endometriosis in the Bartholin gland without surgery in the perineal area. So far, only five cases concerning endometriosis in the Bartholin gland, which may or may not be an isolated finding, have been reported in the literature. Case presentation: A 31-year-old Indo-surinamese woman with primary infertility presented at our outpatient clinic with cyclical vulvar pain. On gynecological examination, a cyst of 1 × 2 cm was found in the right gland of Bartholin. A transvaginal ultrasound revealed normal gynecological anatomy and did not reveal any contributing information. Due to the recurring pain of the cyst, surgery was scheduled. During surgery, the marsupialization of the cyst resulted in drainage of a chocolate-colored fluid. Pathological examination revealed stroma lined with non-typical columnar epithelium with hemosiderin pigments, which confirmed a diagnosis of endometriosis in the Bartholin gland. Conclusion: Our findings revealed a case of endometriosis outside the pelvis, without any deep intraperitoneal involvement. So far, only five cases concerning endometriosis in the Bartholin gland, which may or may not be an isolated finding, have been reported in literature.

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Endometriosis in the Bartholin Gland: A Case Report

Cited by 4 publications

References 6 publications

Diagnosis and Treatment of Vulvo-Perineal Endometriosis: A Systematic Review

Diagnosis and Treatment of Vulvo-Perineal Endometriosis: A Systematic Review

A unique case of isolated vulvar endometriosis

Endometriosis of the Bartholin gland: a case report and review of the literature

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