The n e w e ng l a n d j o u r na l of m e dic i n e

Images in Clinical Medicine

ChanaA. Sacks, M.D., Editor

Gartners Duct Cyst

A B

V
B
G

A
29-year-old woman presented to an outpatient gynecology JacobP. Hoogendam, M.D., Ph.D.
clinic 4 months after an uncomplicated vaginal delivery with a mass pro- Marieke Smink, M.D.
truding from the vaginal canal. She reported no urinary tract symptoms or Elisabeth-TweeSteden Hospital
abnormal vaginal discharge. A physical examination revealed a smooth, nontender Tilburg, the Netherlands
mass, 5 cm in the longest diameter, in the midline of the anterior wall of the vagina j.hoogendam@etz.nl
(Panel A). There was no evidence of pelvic-organ prolapse. A cystoscopic examina-
tion did not reveal a urethral or bladder diverticulum. Magnetic resonance imaging
of the pelvis (Panel B) with contrast medium inserted into the vagina revealed a
cystic structure (G) located between the bladder (B) and the vagina (V). The patient
underwent complete resection of the cyst, which was histologically confirmed to
be a Gartners duct cyst. A Gartners duct cyst is a benign vaginal cystic structure
that arises from the vestigial remnant of the mesonephric (wolffian) duct, which,
during male embryogenesis, forms the seminal vesicles, vas deferens, and epididy-
mis. Gartners ducts are paired structures on either side of the urethra; when cysts
become large, as in this patient, they can appear in the midline. The patient had
an unremarkable postoperative course and had no sign of recurrence 6 weeks after
surgery.
DOI: 10.1056/NEJMicm1609983
Copyright 2017 Massachusetts Medical Society.

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