title: Literature Review of Periclitoral Cysts in the Prepubertal Population.
abstract: OBJECTIVE
  Clitoral cysts in the pediatric population are rare conditions that require careful evaluation. In this review of the literature we discuss the evaluation of clitoral abnormalities in the pediatric population, the development of clitoral cysts, and how to differentiate benign from malignant tumors. In addition, a summary of relevant cases of clitoral tumors in the literature are discussed.
  
  
  METHODS
  Literature review.
  
  
  METHODS
  A MedLine and advanced PubMed search was conducted of all English language articles published using the search terms "clitoris" and "cyst" until February 2015. Reference tracing was completed for all articles for completeness.
  
  
  RESULTS
  Literature review of clitoral cysts in the prepubertal population.
  
  
  RESULTS
  In total, we found 15 cases of benign, spontaneously forming clitoral cysts reported. Eleven of those cases document symptom onset before puberty. Reports of other benign clitoral lesions in the pediatric population include 1 angiokeratoma, 1 hemangiopericytoma, 1 granular cell tumor, 6 hemangiomas, and approximately 30 neurofibromas. Clitoral malignancies in the pediatric population are even more rare with only 3 cases of clitoral schwannomas, 2 rhabdomyosarcomas, 1 lymphoma, and 1 endodermal sinus tumor documented in the literature.
  
  
  CONCLUSIONS
  Clitoral cysts must be considered as a possible cause of clitoral enlargement in the prepubertal population. Clitoral tumors are distinguished clinically from hormonal abnormalities and intersex disorders by their hormonal profile, and the presence of an underlying mass. Ultrasound and magnetic resonance imaging might be useful imaging modalities to further characterize the clitoral enlargement. When confirmed as the most likely diagnosis, surgical resection is the mainstay of treatment for clitoral cysts.
authors.affiliation: Obstetrics and Gynecology, University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada. Electronic address: Kayla.Nelson4@albertahealthservices.ca.
authors.forename: Kayla L
authors.initials: KL
authors.lastname: Nelson
authors.affiliation: Obstetrics and Gynecology, Pediatric Gynecology, University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: McQuillan
authors.affiliation: Obstetrics and Gynecology, Pediatric Gynecology, University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada.
authors.forename: Philippa
authors.initials: P
authors.lastname: Brain
mesh_terms: D002648:Child; D002987:Clitoris / Q000473:pathology; D003560:Cysts / Q000473:pathology*; D005260:Female; D006801:Humans; D006984:Hypertrophy; D012741:Sexual Maturation; D014845:Vulvar Diseases / Q000473:pathology*
keywords: Clitoral cyst; Clitoral enlargement; Prepubescent; Tumor