Symptomatic Giant Skene's Gland Cyst During Second Trimester Pregnancy and Surgical Excision: A Case Report

Introduction: A Skene's gland cyst is a rare gynecological disorder, and the cause of an adult onset is largely unknown. However, periurethral and perineal cystic lesions are common, causing often indistinguishable symptoms. Therefore, accurate diagnosis is crucial because it can significantly alter clinical management. Methods: A 27-year-old woman was gravida 2 para 1 with the onset of a unique, progressively large vulvar mass that began at approximately 6 weeks of gestation. At 22 weeks of gestation, the mass became more symptomatic and measured approximately 9 cm x 7 cm x 6 cm in size, with some areas of excoriation on the lateral surface. Results: The patient had a pelvic MRI without contrast, and it showed that the mass was most likely a giant Skene's gland cyst. At 24 weeks, the mass was surgically removed under spinal anesthesia and followed by vulvar reconstruction. Histopathology showed a benign cyst lined by transitional and squamous epithelium cells, which was consistent with a benign Skene's gland cyst. She recovered fully, continued with the pregnancy and delivered vaginally at 39 weeks and 3 days without complications. Conclusions: A case of excoriating giant Skene's gland cyst in pregnancy that caused significant discomfort to the patient. To this day, there has been no reported literature of a Skene's gland cyst this large, especially during pregnancy. Hence, Skene's gland cysts should be part of the differential diagnosis of a large vulvar mass of this magnitude during pregnancy.