title: Vulvar endometriosis presenting with dyspareunia: a case report.
abstract: BACKGROUND
  Superficial dyspareunia can be caused by a multitude of medical and psychological conditions, including pathologic conditions of the vulva. Although infectious and inflammatory causes are more common, vulvar endometriosis is a rare and often overlooked etiology of dyspareunia.
  
  
  METHODS
  A 33-year-old woman, gravida 1, para 1, presented for a gynecologic consultation with a 2-year history of increasing dyspareunia and cyclical vulvar pain associated with a vulvar mass. Previous treatment with analgesics and sitz baths did not alleviate the symptoms. Pelvic examination revealed a right Bartholin's gland mass that was tender to palpation. The working diagnosis was a Bartholin's cyst as the cause of the dyspareunia, and the patient was scheduled for marsupialization and/or resection. Examination under anesthesia revealed an irregular, 5 cm, solid mass that extended into the labia majora, which was excised. Pathologic examination of the mass revealed endometriosis. The postoperative course was unremarkable and the patient reported complete resolution of symptoms.
  
  
  CONCLUSIONS
  This case illustrates that superficial dyspareunia associated with cyclical vulvar pain can be caused by endometriosis involving the labia majora.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of Medicine and Dentistry of New Jersey--Robert Wood Johnson Medical School, New Brunswick, New Jersey 08901, USA. brugpa@umdnj.edu
authors.forename: Pamela
authors.initials: P
authors.lastname: Brug
authors.forename: Ndeye-Aicha
authors.initials: NA
authors.lastname: Gueye
authors.forename: Gloria
authors.initials: G
authors.lastname: Bachmann
mesh_terms: D000328:Adult; D004414:Dyspareunia / Q000209:etiology*; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D014845:Vulvar Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery