Differentials

Mucous cyst of the vestibule

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Tends to be soft, <2 cm in diameter, superficial, and smooth.[18]

INVESTIGATIONS

Diagnosis is clinical.

Vulval hematoma

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Usually follows trauma or intraoperative bleeding. Extravasated blood may expand in the loose areolar tissue of the labia and cause considerable swelling. This tense swelling is exquisitely painful.[19][20]

INVESTIGATIONS

Diagnosis is clinical.

Vulval fibroma

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Firm, not cystic, may develop pedicle, asymptomatic lesion typically occurring on the labia majora, perineal body, or introitus.[18][19]

INVESTIGATIONS

Diagnosis is clinical.

Vulval lipoma

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Skin-colored, soft, fatty tumor of the subcutaneous tissue; typically asymptomatic and slow growing.[20][Figure caption and citation for the preceding image starts]: Vulval lipomaFrom the personal collection of Colleen Kennedy Stockdale [Citation ends].com.bmj.content.model.Caption@11ce30ef

Usually in the labia majora, and further lipomas may be found on lower abdomen or thighs.[18]

INVESTIGATIONS

Diagnosis is clinical.

Cyst of the canal of Nuck

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Cystic swelling in the inguinal crease or anterior labia majora. Not crossed by the labium minus.

Arises from remnants of peritoneum as it passes through the inguinal canal, so cysts may occur anywhere along the path of the inguinal canal or within the labia majora.

INVESTIGATIONS

Diagnosis is clinical.

Epidermal inclusion cyst (sebaceous, keratinous, or epidermoid cyst)

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

These tend to be asymptomatic, small, and multiple, grouped together on the labia majora.[18]

May have a yellowish appearance and feel firm and knobbly.[20]

INVESTIGATIONS

Diagnosis is clinical.

Malignant lesion of Bartholin gland

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Tends to present in older women (>50 years) as an irregular nodular vulval mass, with or without ulcerations.[3][12][Figure caption and citation for the preceding image starts]: Squamous cell cancerFrom the personal collection of Colleen Kennedy Stockdale [Citation ends].com.bmj.content.model.Caption@36ccb323

INVESTIGATIONS

Biopsy of the lesion confirms or excludes malignancy.

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