Bartholin Gland Diseases Clinical Presentation

Updated: Oct 24, 2022
  • Author: Antonia Quinn, DO; Chief Editor: Erik D Schraga, MD  more...
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Presentation

History

Patients with cysts may present with painless labial swelling. Abscesses may present spontaneously or after a painless cyst with the following symptoms:

  • Acute, painful unilateral labial swelling

  • Dyspareunia

  • Pain with walking and sitting

  • Sudden relief of pain followed by discharge (highly suggestive of spontaneous rupture)

Adenoid cystic carcinoma (ACC) of the Bartholin gland is a rare form of vulval cancer and can present as a vulval mass, with or without symptoms such as pain, ulceration, pruritus, abnormal bleeding, or dyspareunia. It may also present as palpable solid, cystic, or abscessed area within a Bartholin cyst. The mass rarely occurs bilaterally. Clinicians should have heightened suspicion for malignancy when there is palpable solid mass within the cyst, underlying fixation to surrounding tissues, and/or cyst or abscess that does not respond or worsens despite treatment.  [18]   

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Physical Examination

The following physical examination findings are seen in Bartholin abscess, as shown in the image below:

  • Patients typically have an exquisitely tender, fluctuant labial mass with surrounding erythema and edema.

  • In some cases, areas of cellulitis surrounding the abscess may be present.

  • Fever, though not typical in healthy patients, may occur.

  • If the abscess has spontaneously ruptured, purulent discharge may be noted. If completely drained, no obvious mass may be observed.

Bartholin abscess. (Image courtesy of Dr. Gil Shla Bartholin abscess. (Image courtesy of Dr. Gil Shlamovitz.)

The following physical examination findings are seen in Bartholin cysts:

  • Patients may have a painless, unilateral labial mass without signs of surrounding cellulitis.

  • If large, the cyst may be tender.

  • Discharge from ruptured cyst should be nonpurulent.

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