Canaliform Median Raphe cyst: A rare variant of a rare diagnosis

Authors

  • Vedika Barman Department of Dermatology, KVG Medical College and Hospital Sullia, India
  • Manjunath P Department of Dermatology, KVG Medical College and Hospital Sullia, India

Keywords:

Median raphe cyst, perineum, parameatal cyst, canaliform

Abstract

Median raphe cyst are rare lesions, with fewer than 15 case reports from the Indian subcontinent. They are usually present over the midline and ventral aspect of the penis, usually near the glans. They can be present over the glans, penile shaft, scrotum or perineum.  Although present since childhood, they are usually reported by young adults when they increase in size, get infected or cause sexual discomfort. The typical location of the cysts helps in pin pointing the diagnosis. Although asymptomatic, in case of complications like infection, trauma or discomfort they should be referred to an Urologist. Case Report: A 4 year old male patient, presented with multiple cystic, fluctuant, opaque swellings present over the midline of the scrotum, ranging in size from 0.2cmX0.3cm to 0.5cmX0.5cm. They were present since birth and asymptomatic. No other pathology was detected in the genital or perianal area. As the lesion was not any source of discomfort, the mother was offered only reassurance and asked to follow up in case of any complications. Discussion: Median Raphe cysts are rare benign, congenital lesions over the male external genitalia. Histology demonstrates cysts lined by stratified columnar epithelium with no connection to the overlying epithelium. Differentials include epidermal cysts, pilonidal cysts, dermoid cysts etc. The pathogenesis is not fully understood, theories include defective urethral fold closure and ectopic periurethral glands among others. Surgical excision with primary closure leads to definitive cure.

Author Biography

Manjunath P, Department of Dermatology, KVG Medical College and Hospital Sullia, India

 Professor and HOD

References

Amaranathan A, Sinhasan SP, Dasiah SD. Median raphe cysts of the prepucial skin, with triple histological linings: A case report and review of the literature. J Clin Diagn Res. 2013;7:1466-8.

Sharma A, Agrawal S, Vishwanath T, Ghate S, Dhurat R, Chahal K. Parameatal Median Raphe Cyst: A Case Report of a Midline Developmental Defect of True Urogenital Origin. Indian Dermatol Online J. 2020;11(2):216-8.

Mermet P. Congenital cysts of the genitoperineal raphe. Rev Chir. 1895;15:382-435.

Shao HI, Chen TD, Shao HT, Chen HW. Male median raphe cysts: Serial retrospective analysis and histopathological classification. Diagn Pathol. 2012;7:121.

Navalon-Monllor V, Ordono-Saiz MV, Ordono-Dominguez F, Sabater-Marco V, Pallas-Costa Y, Navalon-Verdejo P. Median raphe cysts in men: presentation of our experience and literature review. Actas Urol Esp. 2017;41(3):205-9.

Deliktas H, Sahin H, Celik OI, Erdogan O. Median raphe cyst of the penis. Urol J. 2015;12(4):2287–8.

Park CO, Chun EY, Lee JH. Median raphe cyst on the scrotum and perineum. J Am Acad Dermatol. 2006;55(5 Suppl):S114–5.

Takahashi M, Watanabe T, Sato K, Ohno M, Yamada K, Takezoe T, et al. Congenital median raphe cysts: coexistence of cystic lesions and canal-like lesions. Open J Pediatr.2013;3(3):2.

Neff J. Congenital canals and cysts of the genito-perineal raphe. Am J Surg. 1936;31(2):308-15.

Shiraki IW. Parametal cysts of the glans penis: a report of 9 cases. J Urol. 1975;114(4):544-8.

Cole LA, Helwig EB. Mucoid cysts of the penile skin. J Urol. 1976;115(4):397–400.

Nagore E, Sanchez-Motilla JM, Febrer MI, Aliaga A. Median raphe cysts of the penis: a report of five cases. Pediatr Dermatol. 1998;15(3):191-3.

Asarch RG, Golitz LE, Sausker WF, Kreye GM. Median raphe cysts of the penis. Arch Dermatol. 1979;115(9):1084-6.

Syed, M., Amatya, B. & Sitaula, S. Median raphe cyst of the penis: a case report and review of the literature. J Med Case Reports.2019;13:214.

Persec Z, Persec J, Sovic T, Rako D, Bacalja J, et al. Median Raphe Cyst–Clinical Report and Immunohistochemical Analysis? J Clin Exp Dermatol Res. 2013;S6:011.

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Published

2023-03-05

How to Cite

1.
Barman V, P M. Canaliform Median Raphe cyst: A rare variant of a rare diagnosis. J Pak Assoc Dermatol [Internet]. 2023Mar.5 [cited 2024May19];33(1):302-4. Available from: https://www.jpad.com.pk/index.php/jpad/article/view/2004

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Section

Case Reports