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Background
Cystic lesions of vagina are uncommon and they are usually an incidental finding during gynaecological examination. Vaginal cysts are classified according to their histology, depending on lining epithelium into the following types: mullerian cyst, Bartholin duct cyst, epidermal inclusion cyst, Gartner duct cyst, endometroid cyst and unclassified variety. 1 2 Among them Mullerian cyst constitutes 30%, Bartholin duct cyst 27.5%, Epidermal inclusion cyst 25% and remaining 17.5% is constituted by Gartner duct cyst, endometriotic cyst and unclassified type. 3
This paper illustrates a rare case of large posterior vaginal wall cyst of Mullerian origin.
Case presentation
A 42-year-old multi para came to our outpatient department with a history of mass protruding per vagina since 1 year. Initially, the mass was small in size and insidious in growth. There was no history of associated bowel and bladder disturbances. There was no history of increase in the size of the swelling on straining or lifting heavy weights.
Patient had undergone a spinal surgery 1 year back for backache. Her general and systemic examination was unremarkable. Local examination revealed a cystic mass of size 8x8 cm seen protruding from the vagina. Speculum examination showed the cystic swelling arising from the posterior vaginal wall. Vaginal rugosities over the swelling were absent. Upper limit of the cyst was extending up to 1 cm below the posterior lip of the cervix and lower limit was extending up to the fourchette. There was no cough impulse in the swelling. Cervix was unhealthy (and was bleeding on touch).
Exact size of the uterus could not be made out on bimanual examination due to obesity. However, uterus was retroverted and...