Diagnostic Challenges of an Unusually Large Bartholin Duct Cyst in a Postmenopausal Woman: Clinical, Ultrasound, MRI, and Histopathological Correlation

Saubhagya Dhakal; Sujal Paudel; Apil Upreti; Sujan Ghimire

doi:10.1155/crra/3407030

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Diagnostic Challenges of an Unusually Large Bartholin Duct Cyst in a Postmenopausal Woman: Clinical, Ultrasound, MRI, and Histopathological Correlation

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Diagnostic Challenges of an Unusually Large Bartholin Duct Cyst in a Postmenopausal Woman: Clinical, Ultrasound, MRI, and Histopathological Correlation

Saubhagya Dhakal, Sujal Paudel, Apil Upreti and Sujan Ghimire

Case reports in radiology, Vol.2026, 3407030

06/03/2026

DOI: 10.1155/crra/3407030

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Abstract

Bartholin duct cysts are common benign vulvar lesions, but unusually large cysts in postmenopausal women are rare and may raise concern for malignancy. We report a 56‐year‐old postmenopausal woman with a progressively enlarging right‐sided vulvar mass that was initially misdiagnosed at multiple healthcare levels as a urinary tract infection and a labial abscess. Clinical examination revealed a large, nontender vestibular mass arising from the right Bartholin gland region. Transperineal ultrasound demonstrated a cystic lesion with heterogeneous internal echoes and no internal vascularity. Noncontrast MRI demonstrated a well‐circumscribed purely cystic lesion measuring 5.9 × 5.4 × 4.0 cm with no enlarged regional lymph nodes or invasion of adjacent structures. Surgical marsupialization was performed, and histopathological analysis confirmed a benign Bartholin duct cyst. The patient had an uneventful postoperative course and no recurrence on follow‐up. This case highlights that atypically large Bartholin duct cysts should be considered in the differential diagnosis of vulvar masses in postmenopausal women. Ultrasound and MRI can help characterize lesion morphology and extent, but histopathological confirmation remains essential in atypical presentations to exclude malignancy.

Endometriosis

Lymphatic System

Magnetic Resonance Imaging

Pain

Womens Health

Abscesses

Age groups

Asymmetry

Asymptomatic

Blood products

Cancer

Case reports

Cysts

Erythema

Fever

Lesions

Ultrasonic imaging

Vagina

UIOWA OA Agreement

Details

Title: Subtitle: Diagnostic Challenges of an Unusually Large Bartholin Duct Cyst in a Postmenopausal Woman: Clinical, Ultrasound, MRI, and Histopathological Correlation
Creators: Saubhagya Dhakal - University of Iowa
Sujal Paudel - Tribhuvan University
Apil Upreti - Tribhuvan University
Sujan Ghimire - Tribhuvan University
Resource Type: Journal article
Publication Details: Case reports in radiology, Vol.2026, 3407030
DOI: 10.1155/crra/3407030
ISSN: 2090-6862
eISSN: 2090-6870
Publisher: Wiley
Language: English
Date published: 06/03/2026
Academic Unit: Radiology
Record Identifier: 9985182816702771

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