Clitoral Cyst as a Cause of Ambiguous Genitalia

Linck, Danielle MD; Hayes, Maria F. MD

Department of Obstetrics and Gynecology, Oakwood Healthcare System, Dearborn, Michigan

Address reprint requests to: Maria F. Hayes, MD, Reproductive Endocrinology and Infertility, 109 Medical Office Building, 18101 Oakwood Blvd, Dearborn, MI 48203; E-mail:[email protected].

Received July 23, 2001. Received in revised form January 15, 2002. Accepted January 31, 2002.

Obstetrics & Gynecology99(5 Part 2):p 963-966, May 2002.

Abstract

BACKGROUND

Ambiguous genitalia need appropriate evaluation, because a serious disease can manifest as this condition.

CASE

A 28-year-old woman was referred with a “penis” present from age 12 years that enlarged throughout puberty but recently was unchanged. Differential diagnosis included true hermaphroditism; adrenal hyperplasia; clitoral, ovarian, and adrenal neoplasms; stromal hyperthecosis; polycystic ovarian syndrome; and exogenous androgen exposure. Free testosterone was not elevated. Dehydroepiandrosterone sulfate, 17-hydroxyprogesterone, total testosterone, androstenedione, deoxycorticosterone, 11-deoxycortisol, chromosomal analysis (46, XX), an intravenous pyelogram, and pelvic ultrasound were normal. The patient elected surgical removal. The mass was a chronic inflamed epidermoid cyst.