title: Clitoral cyst as a cause of ambiguous genitalia.
abstract: BACKGROUND
  Ambiguous genitalia need appropriate evaluation, because a serious disease can manifest as this condition.
  
  
  METHODS
  A 28-year-old woman was referred with a "penis" present from age 12 years that enlarged throughout puberty but recently was unchanged. Differential diagnosis included true hermaphroditism; adrenal hyperplasia; clitoral, ovarian, and adrenal neoplasms; stromal hyperthecosis; polycystic ovarian syndrome; and exogenous androgen exposure. Free testosterone was not elevated. Dehydroepiandrosterone sulfate, 17-hydroxyprogesterone, total testosterone, androstenedione, deoxycorticosterone, 11-deoxycortisol, chromosomal analysis (46,XX), an intravenous pyelogram, and pelvic ultrasound were normal. The patient elected surgical removal. The mass was a chronic inflamed epidermoid cyst.
  
  
  CONCLUSIONS
  If this patient had been appropriately evaluated earlier, she would have been spared anxiety and embarrassment over a simple epidermoid cyst.
authors.affiliation: Department of Obstetrics and Gynecology, Oakwood Healthcare System, Dearborn, Michigan, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Linck
authors.forename: Maria F
authors.initials: MF
authors.lastname: Hayes
mesh_terms: D000307:Adrenal Gland Diseases / Q000175:diagnosis*; D000311:Adrenal Glands / Q000473:pathology; D000328:Adult; D002987:Clitoris; D003937:Diagnosis, Differential; D012734:Disorders of Sex Development / Q000175:diagnosis*; D004814:Epidermal Cyst / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D006965:Hyperplasia; D014845:Vulvar Diseases / Q000175:diagnosis* / Q000601:surgery; D014846:Vulvar Neoplasms / Q000175:diagnosis