Nelson Kayla L, McQuillan Sarah K, Brain Philippa
Obstetrics and Gynecology, University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada.
Obstetrics and Gynecology, Pediatric Gynecology, University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada.
J Pediatr Adolesc Gynecol. 2016 Dec;29(6):558-561. doi: 10.1016/j.jpag.2016.05.005. Epub 2016 May 27.
Clitoral cysts in the pediatric population are rare conditions that require careful evaluation. In this review of the literature we discuss the evaluation of clitoral abnormalities in the pediatric population, the development of clitoral cysts, and how to differentiate benign from malignant tumors. In addition, a summary of relevant cases of clitoral tumors in the literature are discussed.
Literature review.
A MedLine and advanced PubMed search was conducted of all English language articles published using the search terms "clitoris" and "cyst" until February 2015. Reference tracing was completed for all articles for completeness.
Literature review of clitoral cysts in the prepubertal population.
In total, we found 15 cases of benign, spontaneously forming clitoral cysts reported. Eleven of those cases document symptom onset before puberty. Reports of other benign clitoral lesions in the pediatric population include 1 angiokeratoma, 1 hemangiopericytoma, 1 granular cell tumor, 6 hemangiomas, and approximately 30 neurofibromas. Clitoral malignancies in the pediatric population are even more rare with only 3 cases of clitoral schwannomas, 2 rhabdomyosarcomas, 1 lymphoma, and 1 endodermal sinus tumor documented in the literature.
Clitoral cysts must be considered as a possible cause of clitoral enlargement in the prepubertal population. Clitoral tumors are distinguished clinically from hormonal abnormalities and intersex disorders by their hormonal profile, and the presence of an underlying mass. Ultrasound and magnetic resonance imaging might be useful imaging modalities to further characterize the clitoral enlargement. When confirmed as the most likely diagnosis, surgical resection is the mainstay of treatment for clitoral cysts.
小儿阴蒂囊肿是罕见病症，需要仔细评估。在本次文献综述中，我们讨论小儿阴蒂异常的评估、阴蒂囊肿的形成以及如何区分良性与恶性肿瘤。此外，还讨论了文献中阴蒂肿瘤相关病例的总结。
文献综述。
截至2015年2月，使用搜索词“阴蒂”和“囊肿”对所有发表的英文文章进行了医学文献数据库（MedLine）和高级PubMed搜索。为确保完整性，对所有文章都进行了参考文献追溯。
青春期前人群阴蒂囊肿文献综述。
我们总共发现15例良性、自发形成的阴蒂囊肿报告。其中11例记录了青春期前出现症状。小儿人群中其他良性阴蒂病变的报告包括1例血管角化瘤、1例血管外皮细胞瘤、1例颗粒细胞瘤、6例血管瘤和约30例神经纤维瘤。小儿人群中的阴蒂恶性肿瘤更为罕见，文献中仅记录了3例阴蒂神经鞘瘤、2例横纹肌肉瘤、1例淋巴瘤和1例内胚窦瘤。
阴蒂囊肿必须被视为青春期前人群阴蒂增大的可能原因。阴蒂肿瘤在临床上可通过其激素水平和潜在肿块的存在与激素异常和两性畸形疾病相区分。超声和磁共振成像可能是进一步明确阴蒂增大特征的有用影像学检查方法。当确诊为最可能的诊断时，手术切除是阴蒂囊肿的主要治疗方法。
