Presentation
Chronic pelvic pain with dyspareunia.
Patient Data
There is a well-defined cystic lesion arising from the right lateral vaginal wall, located above the level of the most inferior aspect of the pubic symphysis, measuring 40 x 30 x 25 mm with a mass effect on the vaginal lumen. It displays a high signal on T1 and T2 (proteinaceous content) with no peripheral enhancement.
Anteverted retroflexed uterus
Normal appearance of the ovaries
Minimal effusion in Douglas pouch.
Case Discussion
MRI features most consistent with a Gartner duct cyst. Both kidneys were normal on ultrasound (not shown), excluding the possibility of associated urinary system anomalies.
Gartner duct cysts are typically located above the inferior aspect of the pubic symphysis, within the walls of the vagina. They are often noticed incidentally on ultrasound or MRI, the symptoms are usually due to the mass effect on adjacent structures.
The main differential diagnosis includes:
- Bartholin gland cyst: usually located at or below the level of the pubic symphysis
- urethral diverticulum: located around the urethra
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