130 Gartner Duct Cyst

Clinical Presentation

A 28-year-old woman presents with pelvic pain and dyspareunia.

Fig. 130.1 (A–C) Axial, sagittal, and coronal T2-weighted images of the pelvis show a well-defined T2 hyperintense lesion (arrows) located within the wall of the left vaginal fornix. (D) T1-weighted axial image after intravenous gadolinium administration shows mild peripheral rim enhancement in the lesion (arrow).

Radiologic Findings

Axial, sagittal, and coronal T2-weighted images of the pelvis (Fig. 130.1A,B,C) show a well-defined T2 hyperintense lesion located within the wall of the left vaginal fornix; after intravenous gadolinium administration, the lesion shows mild peripheral rim enhancement (Fig. 130.1D).

Diagnosis

Gartner duct cyst

Differential Diagnosis

Urethral diverticula
Skene cyst
Duplication cyst
Endometriotic implants
Bartholin gland cyst

Discussion

Background

Gartner duct cysts derive from the vestigial remnant of the vaginal portion of the mesonephric (wolffian) duct; in the case of incomplete involution, cysts may develop due to secretion by persistent glandular tissue. Remnants of the mesonephric duct may be found in one fourth of women, although the cysts are rarely described (1–2%). Gartner cysts are typically paravaginal and located within the anterolateral aspect of the proximal third of the vagina.