Bewilderment in Bartholins Gland -An Unusual Location of Endometriosis

Endometriosis is a condition in which endometrial glands and stroma grow outside the endometrial cavity most often involving   the pelvic cavity mainly the ovaries and dependent peritoneal surfaces. Endometriosis in bartholins gland is an extremely rare presentation. Only six cases have been reported in the world literature so far in women less than 35 years of age A 46-year-old multiparous lady was admitted in our hospital with the complaint of a persistent swelling in the right vulvar region for past 6 months. The swelling was found be more prominent during menstruation. Local Examination revealed a 4x6 cm cystic, non-fluctuant and non-tender mass was present in the right labia minora. The initial diagnosis of Bartholin gland cyst was made and the patient was planned for Bartholin cyst marsupialization. Intraoperatively the cyst ruptured during dissection and dark chocolate brown fluid was drained. Pathological examination confirmed the diagnosis of endometriosis. Endometriosis in the Bartholin gland being an underdiagnosed one, it should be considered there is cyclical pain& swelling of the Bartholin gland. Complete Surgical excision and histopathologic examination is necessary for a definitive diagnosis.