Subpubic cartilaginous cyst: an unusual cause of a vulval mass

Abstract

We present a case of a postmenopausal female who visited her doctor for a slowly growing mass in the vulval region. The mass did not show typical clinical features of a vulval neoplasm. Magnetic resonance imaging (MRI) revealed a mass arising from the undersurface of the symphysis pubis. A literature review revealed characteristics of this lesion compatible with a subpubic cartilaginous cyst-a rare benign degenerative condition of the symphysis pubis. As a result the mass was managed non-operatively and the patient remains well 2 years later. This article highlights the role of MRI in the diagnosis of this unusual vulval mass.

Surgical approach to a vulval–pubic cartilaginous cyst: A case report and review of published work

“…The largest reported size is 5 cm in the current case. Patients usually present in the sixth decade of life with complaint of a mass or swelling in the vulval–pubic region, with or without pain . Urinary symptoms were present in four cases and the symptoms were voiding dysfunction and sensation of incomplete bladder emptying .…”

“…Radiological imaging typically includes X‐ray, computed tomography scan or MRI . X‐ray would help to indentify degenerative sclerosis, narrowing of the pelvic joint or widening of the pubic symphysis.…”

“…Therefore, a preoperative biopsy was not carried out. Due to the very high sensitivity of an MRI in defining the nature of the cyst, preoperative biopsies and intraoperative frozen section analysis should be limited to the cases with a high index of suspicion of malignancy.…”

Subpubic cartilaginous cyst: a rare cause of dysuria

“…The most frequent clinical presentation is a vulvar mass (5,6). Dysuria, sharp pain and incomplete bladder dysfunction has been described as well (4).…”

“…The differential diagnosis of vulvar cystic lesions includes Nabothian cysts, Bartholin's cysts, Gartner's cysts, urethral diverticulum and rarely malignant neoplasms (6,8). The most valuable imaging clues to the correct diagnosis of the lesion are …”