Median raphe cysts of the prepucial skin, with triple histological linings: a case report and review of the literature

Abstract

A median raphe cyst is an uncommon entity. An extensive literature search has revealed only less than 200 reported cases. Among these, only less than 10 have been reported from the Indian subcontinent. Usually, it is located in the midline, anywhere between the urethral meatus and the anus. We are presenting a case of a prepucial median raphe cyst, which occurred at a very uncommon location, which presented with symptoms, which is also a rare scenario. This case has been presented for its rare location, uncommon clinical presentation and an interesting triple lining presentation in histology.

Keywords: Median raphe cyst; Penile cyst; Prepucial cyst.

[Table/Fig-1]:

Pre-operative photograph showing globular swelling present over the prepucial skin on the ventral side of penis

[Table/Fig-2]:

Histopathology showing a cystic lesion covered with skin and areas of sub-cutaneous tissue showing fibromuscular stromal connective tissue. Cyst lining varied from areas to area (H&E, 4X)

[Table/Fig-3]:

Cyst lined with stratified cuboidal to flat to transitional type of epithelium with focal areas showing fine cilia (H&E, 10X)

[Table/Fig-4]:

A focal area showing apocrine snouting over the stratified cuboidal lining with dense lymphocyte and plasma cell infiltrate in the sub-epithelial tissue (H&E, 40X)