Skene's duct cyst

A 1dayold female infant with an interlabial mass was referred by gynecologists to pediatricians. The patient was born via vaginal delivery without any complications at 40 weeks of gestational age, with a birthweight of 3100 g. On physical examination, a smooth, soft, white, and ovoid mass covered with small vessels on the surface projected from the vagina, although the patient had no symptoms (Figure 1, panels A and B). The mass was suspected to be Skene’s duct cyst owing to its location and gross features. Needle aspiration was performed after confirmation of the fluid content on ultrasonography. The needle aspiration revealed milky fluid in the cyst, which was clinically diagnosed as Skene’s duct cyst (Panel C). Skene’s duct cyst is a rare congenital anomaly in female neonates. The etiology of the cyst is still unknown, although obstruction of Skene’s duct as a result of infection or inflammation, or cystic degeneration of embryonic remnants of the paraurethral glands has been postulated.1 While an observational strategy is acceptable because of the tendency of the cyst to resolve spontaneously,2 most of the previous reports recommended surgical intervention because the cyst may interfere with urinary excretion.3 Needle aspiration, excision, and marsupialization are equally effective treatment methods for Skene’s duct cysts.2 In particular, needle aspiration is a preferable alternative because it is less invasive than the other interventions.4 In this case, no recurrence was observed a month after the needle aspiration. Regardless of the fact that Skene’s duct cyst can be diagnosed using physical examination alone, if physicians are not aware of the mass, invasive tests or radiographic examination might be performed. Therefore, remembering the gross feature of Skene’s duct cyst might