Fux-Otta Carolina, Fuster Margarita, Ramos Noelia, Trezza Cristina, Ñañez Mónica, Fonseca Ismael, Dicuatro Néstor, Di Carlo Mariana, Bongiorni Carla, Ochoa José, Rosato Otilio, Chedraui Peter
Departamento de Endocrinología y Diabetes, Hospital Universitario de Maternidad y Neonatología, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba Capital, Argentina.
Unidad de Conocimiento Traslacional Hospitalaria, Hospital Universitario de Maternidad y Neonatología, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba Capital, Argentina.
Case Rep Womens Health. 2022 Jul 18;35:e00432. doi: 10.1016/j.crwh.2022.e00432. eCollection 2022 Jul.
Clitoromegaly is often a sign of androgen excess; however, non-hormonal causes must be ruled out. We report the case of an adolescent with isolated clitoromegaly without clinical or biochemical evidence of hyperandrogenism.
A 16-year-old female was referred due to a clitoromegaly of 12 months of evolution. Examination of the pubic region revealed normal female genitalia with an enlarged clitoris, 4 cm long and 2.5 cm wide. The clitoris was painless, soft on palpation, and mobile over deeper layers. There were no signs of virilization, and the patient did not report dysuria or difficulties with sexual intercourse. Her medical record was also unremarkable, with no female circumcision, family history of birth defects, or genital abnormalities. Hormone profile blood tests were normal. Pelvic ultrasound examination was normal, but a high-resolution scan with a linear transducer confirmed the presence of a cyst, lying anterior to the clitoral body and glans. The cyst was surgically removed with special care to preserve the clitoral neurovasculature. The pathological report disclosed an epidermoid clitoral cyst. The patient described emotional well-being, satisfactory sexual function, and no discomfort after a year of follow-up.
Epidermal clitoral cysts represent an unusual cause of clitoromegaly. These cysts should be ruled out as a differential diagnosis after an exhaustive semiological and endocrinological examination.
阴蒂肥大通常是雄激素过多的表现；然而，必须排除非激素性病因。我们报告一例青春期女性，其孤立性阴蒂肥大，无高雄激素血症的临床或生化证据。
一名16岁女性因阴蒂肥大12个月前来就诊。检查发现耻骨区女性生殖器正常，但阴蒂增大，长4厘米，宽2.5厘米。阴蒂无痛，触诊柔软，在深层可活动。无男性化体征，患者未诉排尿困难或性交困难。其病历也无异常，无女性割礼、出生缺陷家族史或生殖器异常。激素水平血液检查正常。盆腔超声检查正常，但线性探头高分辨率扫描证实阴蒂体和阴蒂头前方存在一个囊肿。手术小心切除囊肿，注意保留阴蒂神经血管。病理报告显示为表皮样阴蒂囊肿。随访一年后，患者表示情绪良好，性功能满意，无不适。
表皮样阴蒂囊肿是阴蒂肥大的罕见病因。在进行详尽的症状学和内分泌学检查后，应将这些囊肿作为鉴别诊断予以排除。
