What are the other Names for this Condition? (Also known as/Synonyms)

• Cutaneous Ciliated Müllerian Cyst of Vulva
• Paramesonephric Ciliated Cyst of Vulva
• Vulvar Ciliated Cyst

What is Ciliated Cyst of Vulva? (Definition/Background Information)

• Ciliated Cyst of Vulva (CCV) is a very rare type of fluid-filled vulvar cyst that is mostly seen in young adult women. Some reports indicate that cysts may occasionally form due to hormonal imbalance, such as caused by pregnancy or hormonal intake (exogenous factors)
• There are many causes attributed to the formation of Ciliated Cyst of Vulva including displaced Müllerian tissue remnants (during fetal development) or from urogenital sinus remnants
• A majority of these cysts are small; larger cysts may cause pain and discomfort. In some cases, the cysts may get infected resulting in abscess formation
• Treatment course includes observation of the lesions in asymptomatic cases and surgical management, if necessary. In general, the prognosis of Ciliated Cyst of Vulva is excellent, since it is benign

Who gets Ciliated Cyst of Vulva? (Age and Sex Distribution)

• Ciliated Cysts of Vulva are very uncommon lesions. They are mostly observed in young adult women (in the 25-35 year age group), but may be rarely seen in young girls (age over 10 years)
• There is no known geographical, ethnic, or racial preference

What are the Risk Factors for Ciliated Cyst of Vulva? (Predisposing Factors)

No specific risk factors have been identified for Ciliated Cysts of Vulva.

• Very rarely, the condition may be associated with an external administration of hormone (such as progesterone)
• Occasionally, pregnancy may influence its formation

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Ciliated Cyst of Vulva? (Etiology)

Ciliated Cysts of Vulva may be caused by longstanding inflammation of the vulva (the area around the external vaginal opening), which occurs due to various factors. The cause of formation of these cysts may also include:

• Abnormal or displaced Müllerian tissue remnants during fetal growth and development
• Abnormalities during embryological development
• Change of one cell type to another, also known as ciliated epithelial cell metaplasia
• Some study reports also indicate that such ciliated cysts may arise from the urogenital sinus-derived epithelium; glands lined by the ciliated epithelium become obstructed and inflamed

It is important to note that Vulvar Ciliated Cysts are not caused by any sexually transmitted disease.

What are the Signs and Symptoms of Ciliated Cyst of Vulva?

A majority of the cysts may be asymptomatic, presenting no significant signs and symptoms. In some cases, the following signs and symptoms of Ciliated Cyst of Vulva may be noted:

• The cyst may be present in any region of the vulva, but are more frequently noted in the inner lips of the vulva (the labia minora)
• The cysts are typically solitary and multi-focal cysts are not reported
• The size of the hard mass may range from 1-3 cm; the mass may appear pedunculated
• An area of redness and inflammation may be observed; there may be an absence of pain
• Large sizes may cause discomfort and pain
• Pain or discomfort while using a tampon, or during sex
• Discomfort while walking or sitting

How is Ciliated Cyst of Vulva Diagnosed?

A diagnosis of Ciliated Cyst of Vulva may involve the following steps:

• Evaluation of the individual’s medical history and a thorough physical (pelvic) examination. A pelvic (visual) exam is normally sufficient to diagnose the condition
• Tests to rule out sexually-transmitted infections (if necessary)
• Biopsy of the mass: It is the process of removing tissue for examination. In the case of ciliated cyst, a complete excision and removal of the lesion can help in the process of a biopsy, as well as be a means for treating the condition
• Occasionally, since the cyst is fluctuant (due to accumulation of fluid), a fine needle aspiration of the cyst contents may be performed
  • Fine needle aspiration (FNA) biopsy: A very fine and hollow needle is inserted where the cyst is noticed; the fluid contained within the cyst is withdrawn. The extracted sample is sent for further pathological examination
  • If the healthcare provider suspects an infection process, then culture studies on the cyst aspirate may be performed

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Ciliated Cyst of Vulva?

No significant complications of Ciliated Cyst of Vulva are noted, because it is a benign condition. However, the following may be observed in some cases:

• Higher risk for abscess formation resulting in infections (especially bacterial infections due to Gonorrhea and Chlamydia); this may result in associated signs and symptoms
• Severe pain during sex, if the cysts are infected and painful
• Damage to the muscles, vital nerves, and blood vessels, during surgery
• Post-surgical infection at the wound site is a potential complication
• Recurrence of the cyst, which is generally uncommon

How is Ciliated Cyst of Vulva Treated?

If there are no symptoms, then the healthcare provider may advise a ‘wait and watch’ approach, following the diagnosis of ciliated cysts. An analysis of risk versus benefit for a ‘wait and watch’ approach will be considered on a case-by-case basis by the healthcare provider.

Treatment measures for Ciliated Cyst of Vulva may include the following:

• Some cysts may subside and spontaneously regress on their own
• Sitz bath: Immersing oneself several times in a tub filled with warm water for a period of 3-4 days may cause the cyst to break and the fluid to drain out on its own. This therapy may not be effective for all individuals. The healthcare provider will advise if the therapy is appropriate for the individual
• Application of topical creams and gels, to bring relief from the symptoms and to provide a measure of comfort
• Stopping the usage of soaps and body creams that have harsh chemicals in them; use of milder alternatives
• Use of clean cotton underwear; avoiding synthetic and tight-fitting clothes for a period of time
• Maintain proper personal hygiene, especially in the genital region
• In some cases, the cysts may get secondarily infected. If bacteria is the cause of infection, it may be treated through antibiotics
• If the antibiotics does not clear the infection, then an abscess drainage through a surgical procedure may be performed
• Surgical intervention with complete excision can result in a complete cure
• Post-operative care is important: Minimum activity level is to be ensured until the surgical wound heals
• Follow-up care with regular screening and check-ups are important

How can Ciliated Cyst of Vulva be Prevented?

Current medical research has not established a method of preventing Ciliated Cyst of Vulva.

• In case of a secondary infection it is better to avoid sex, as it may aggravate the condition
• After bowel movement, clean or wipe from front to back and avoid spread of pathogens from the rectum to vagina
• Ensure good genital hygiene
• Avoid tight-fitting dress that trap moisture between the legs

Medical screening at regular intervals with scans and physical examinations are advised.

What is the Prognosis of Ciliated Cyst of Vulva? (Outcomes/Resolutions)

• The prognosis of Ciliated Cyst of Vulva is excellent with adequate treatment, since it is a benign lesion
• However, if the cysts are infected, then it may worsen the prognosis

Additional and Relevant Useful Information for Ciliated Cyst of Vulva:

The following DoveMed website links are useful resources for additional information:

http://www.dovemed.com/healthy-living/womens-health/

http://www.dovemed.com/diseases-conditions/cancer/