Presentation
Pregnant woman with perineal swelling and pain.
Patient Data
Location is key: anterior vaginal wall, at symphysis level, paramedian to urethra.
Round image with thick walls, internal isointense T1 to muscle signal and mildly heterogenous isointense/hyperintense T2 to muscle. Peripheral swelling.
Contrast injection has not been performed because of pregnancy.
Perineal US to confirm the lack of internal vascularization, thus ruling out a tumor.
Perineal US shows the paraurethral lesion with thick, hypervascular walls, internal echogenic debris, mild acoustic enhancement and no internal Doppler signal.
Appearances consistent with abscess.
Case Discussion
In female perineal cystic lesions, location is key.
Radiological diagnosis is paraurethral duct abscess.
Refer to the gamuts cystic lesions around vagina and female urethra.