THINKING BEYOND THE CYST: VULVAR ENDOMETRIOSIS MIMICKING A RECURRENT BARTHOLINS GLAND CYST - A CASE REPORT

Background:-Vulvar endometriosis is a rare form of extra pelvic endometriosis that may be easily mistaken for a Bartholin’s gland cyst or abscess. Misdiagnosis delays appropriate treatment and leads to repeated, ineffective procedures. Case Presentation:- A 32-year-old woman presented in July 2026 with recurrent, painful swelling of the left vulva that began in February 2024. The symptoms worsened every time with menstruation. In early 2025, the mass ruptured spontaneously on two occasions, discharging dark brown fluidmixed with old blood.She underwent incision and drainage with marsupializationinMarch2025forapresumed Bartholin’s abscess. She had another cyst excision in December 2025.The mass recurred within two months of the procedure on both occasions. Examination revealed a7cm tender, irregular, predominantly cystic mass in the left labia, extending into the vagina and posterior fourchette. Ultrasound showed a cystic lesion in the anatomical region of the Bartholin’s gland. The mass was homogeneous, had low-level internal echoes, without septations, papillary projections or internal vascularity on color Doppler.