Mulu Tadie Siraw, Nur Wali Ahmed, Fetene Moges Addis, Hussen Mohamed Mahdi, Molla Daniel Kassie, Ayen Addisu Assfaw
Department of obstetrics and gynecology, Garbo primary hospital, Somali, Ethiopia.
Garbo primary hospital, Somali, Ethiopia.
Int J Surg Case Rep. 2025 Aug;133:111660. doi: 10.1016/j.ijscr.2025.111660. Epub 2025 Jul 10.
The female external genitalia can be affected by various tumors, benign and malignant, including those of the clitoris. Clitoral epidermoid cysts are a rare late complication associated with female genital mutilation (FGM). FGM, as defined by the WHO, is a human rights violation performed for non-medical reasons. Despite efforts to eradicate FGM, it remains prevalent in parts of sub-Saharan Africa and other regions, impacting an estimated 100 million women globally.
Three women from Garbo, Somali region, Ethiopia (A 36-year-old para 8 presenting with a 12-year history of progressive vulvar swelling after undergoing FGM at age 6, An 18-year-old nulligravida presenting with a 5-year history of progressively enlarging vulvar swelling after undergoing FGM at age 5 years and A 28-year-old para 5 mother with history of 9 years vulvar swelling) presented from rural Ethiopia. Physical exam revealed varying sizes of clitoral masses in all patients, with normal other findings. Biopsy suggested clitoral epidermoid cysts. They were managed with surgical removal and reconstruction.
Clitoral epidermoid inclusion cysts, rare benign masses typically found elsewhere on the body, can present as swelling requiring differentiation from clitoromegaly. While often associated with trauma, they can arise as a long-term complication of Female Genital Mutilation. Diagnosis involves clinical and histologic examination. Management of clitoral cysts involves enucleation and reconstruction, as exemplified in this case. Post-operative care addresses potential complications like sexual dysfunction, cosmetic issues, UTIs, obstetric sequelae, psychological concerns, and recurrence, none of which were reported by the patient at follow-up.
Clitoral epidermoid inclusion cysts are rare complications of trauma, including FGM, which remains a challenge in low-income countries following FGM. Prevention and surgical management are key to improving outcomes and quality of life.
女性外生殖器可受到各种良性和恶性肿瘤的影响，包括阴蒂肿瘤。阴蒂表皮样囊肿是一种与女性生殖器切割（FGM）相关的罕见晚期并发症。世界卫生组织（WHO）将女性生殖器切割定义为出于非医疗原因实施的侵犯人权行为。尽管为消除女性生殖器切割做出了努力，但它在撒哈拉以南非洲部分地区和其他地区仍然普遍存在，全球估计有1亿女性受到影响。
三名来自埃塞俄比亚索马里州加尔博的女性（一名36岁经产妇，6岁时接受女性生殖器切割后有12年逐渐加重的外阴肿胀病史；一名18岁未孕女性，5岁时接受女性生殖器切割后有5年逐渐增大的外阴肿胀病史；一名28岁经产妇，有9年外阴肿胀病史）从埃塞俄比亚农村前来就诊。体格检查发现所有患者阴蒂肿物大小各异，其他检查结果正常。活检提示为阴蒂表皮样囊肿。她们接受了手术切除和重建治疗。
阴蒂表皮样包涵囊肿是罕见的良性肿物，通常见于身体其他部位，可表现为肿胀，需要与阴蒂肥大相鉴别。虽然常与创伤有关，但它们可作为女性生殖器切割的长期并发症出现。诊断包括临床和组织学检查。阴蒂囊肿的治疗包括摘除和重建，本病例就是例证。术后护理要关注性功能障碍、美容问题、尿路感染、产科后遗症、心理问题和复发等潜在并发症，随访时患者均未报告出现这些情况。
阴蒂表皮样包涵囊肿是包括女性生殖器切割在内的创伤的罕见并发症，在低收入国家，女性生殖器切割后仍然是一个挑战。预防和手术管理是改善预后和生活质量的关键。
