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Epithelial Inclusion Cysts of Vulva

Last updated Sept. 10, 2018

Approved by: Krish Tangella MD, MBA, FCAP

Epithelial Inclusion Cysts of Vulva is a type of vulvar cyst that forms due to entrapment of surrounding epithelial tissue. It is a benign cyst that is lined by stratified (non-keratinizing) squamous epithelium, when observed under a microscope by a pathologist.


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

  • Squamous Epithelial Vulvar Inclusion Cysts
  • Squamous Inclusion Cysts of Vulva
  • Vulvar Epithelial Inclusion Cysts

What is Epithelial Inclusion Cysts of Vulva? (Definition/Background Information)

  • Vulvar cysts are rare, benign, and usually fluid-filled lesions that form on the vulvar region (the area around the external vaginal opening) in adult women. A majority of these cysts are small and present no symptoms, while some may grow larger resulting in pain and discomfort
  • Epithelial Inclusion Cysts of Vulva is a type of vulvar cyst that forms due to entrapment of surrounding epithelial tissue. It is a benign cyst that is lined by stratified (non-keratinizing) squamous epithelium, when observed under a microscope by a pathologist
  • There are no clearly established risk factors, but Epithelial Inclusion Cysts of Vulva are known to form due to trauma to the vaginal walls (such as due to surgery)
  • Most of the cysts appear as solitary mucin-filled lesions and are painless. No significant signs and symptoms or complications are typically noted. However, in some cases, Epithelial Inclusion Cyst of Vulva may cause tenderness, pain, and discomfort
  • Treatment course includes close observation of the tumor in asymptomatic cases and surgical management, if necessary. In general, the prognosis of Epithelial Inclusion Cyst of Vulva is excellent with adequate treatment

Who gets Epithelial Inclusion Cysts of Vulva? (Age and Sex Distribution)

  • Epithelial Inclusion Cysts of Vulva are mostly observed in adult women
  • There is no known geographical, ethnic, or racial preference

What are the Risk Factors for Epithelial Inclusion Cysts of Vulva? (Predisposing Factors)

No definitive risk factors have been identified for Epithelial Inclusion Cysts of Vulva. However, they may occur due to the following factors:

  • Trauma to the vagina/vulva during childbirth or occurring due to other reasons: The condition is termed Traumatic Vulvar Epithelial Inclusion Cyst
  • Presence of other benign genital tumors
  • Invasive procedures involving the female genital tract, such as colposcopic exam, endocervical curetting, episiotomy, colporrhaphy, and laser therapy, that are performed for various reasons

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 Epithelial Inclusion Cysts of Vulva? (Etiology)

  • Epithelial Inclusion Cysts of Vulva are caused by displaced epithelium that occurs due to variety of factors including trauma and abnormal congenital epithelial remnants during fetal growth and development
  • Surgical trauma is also an important causative factor

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

What are the Signs and Symptoms of Epithelial Inclusion Cysts 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 Epithelial Inclusion Cysts of Vulva may be noted:

  • Presence of a single cyst that is normally filled with fluid (usually mucin); the cysts may be also sometimes filled with pus, air, or other cell remnants
  • The cyst is soft and usually well-defined; it may occur as a polyp on the vulvar region
  • The cysts may be of varying sizes; most cysts are small (less than 1 cm), while some may grow to large sizes
  • 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
  • It may also cause itching and painful urination

How is Epithelial Inclusion Cysts of Vulva Diagnosed?

A diagnosis of Epithelial Inclusion Cysts 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 epithelial inclusion 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 Epithelial Inclusion Cysts of Vulva?

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

  • Abscess formation resulting in infections; this may result in associated signs and symptoms including fever
  • Severe pain during sex, if the cysts are infected and painful
  • The cysts may rupture and bleed resulting in secondary infections
  • 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

How is Epithelial Inclusion Cysts of Vulva Treated?

Treatment measures for Epithelial Inclusion Cysts of Vulva may include the following:

  • Some cysts are known to subside and spontaneously regress on their own
  • If there are no symptoms, then the healthcare provider may advise a ‘wait and watch’ approach, following the diagnosis of a epithelial inclusion cyst
  • 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 will drain 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
  • Stoppage 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 Epithelial Inclusion Cysts of Vulva be Prevented?

Current medical research has not established a method of preventing Epithelial Inclusion Cysts 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 Epithelial Inclusion Cysts of Vulva? (Outcomes/Resolutions)

The prognosis of Epithelial Inclusion Cysts of Vulva is excellent with surgical intervention (surgical removal through simple excision), since these are benign lesions.

Additional and Relevant Useful Information for Epithelial Inclusion Cysts 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/

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Nov. 5, 2016
Last updated: Sept. 10, 2018