Differential Diagnosis for Bartholin Cyst

Single Most Likely Diagnosis

• Bartholin Cyst: This is the most likely diagnosis due to the typical presentation of a painful, localized cyst on the labia, which is consistent with a Bartholin gland cyst. The Bartholin glands are located on each side of the vaginal opening and can become blocked, leading to cyst formation.

Other Likely Diagnoses

• Bartholin Abscess: An abscess is a collection of pus that can form in the Bartholin gland, often as a result of infection. It presents similarly to a cyst but is usually more painful and may have signs of infection such as redness, warmth, and purulent discharge.
• Vulvar Cyst: Other types of cysts can occur on the vulva, including epidermal inclusion cysts, which are benign cysts that can form in the skin.
• Folliculitis or Furuncle: Inflammation of the hair follicles (folliculitis) or a more severe infection of the follicle and surrounding tissue (furuncle) can mimic a Bartholin cyst in presentation.

Do Not Miss Diagnoses

• Malignancy (e.g., Adenocarcinoma of the Bartholin Gland): Although rare, any vulvar mass should be evaluated for the possibility of malignancy, especially in postmenopausal women or those with a history of cancer.
• Necrotizing Fasciitis: A severe, life-threatening infection that can occur in the vulvar area, characterized by rapid progression of symptoms including severe pain, swelling, and signs of systemic infection.
• Sexually Transmitted Infections (STIs): Certain STIs, such as genital herpes or syphilis, can cause ulcers or lesions that might be confused with a Bartholin cyst.

Rare Diagnoses

• Hydrocele of the Labia: A rare condition where fluid accumulates in the labia, which can mimic a cyst.
• Vulvar Lipoma: A benign tumor composed of fat tissue that can occur on the vulva.
• Dermoid Cyst: A type of cyst that can occur on the vulva, containing skin and sometimes hair, teeth, or other tissue.

Treatment

Treatment for a Bartholin cyst typically involves managing symptoms and may include:

• Sitz baths to promote drainage and comfort
• Antibiotics if there is evidence of infection
• Incision and drainage for abscesses
• Marsupialization or Word catheter placement for larger cysts to create a new tract for drainage
• Excision of the Bartholin gland in recurrent cases or if malignancy is suspected.