A Giant Suppurative Nabothian Cyst Presenting as a Prolapsing Cervical Mass: Diagnostic Pitfalls and Surgical Management: A Case Report

Abstract

Background: Nabothian cysts are benign mucous retention cysts of the uterine cervix, typically small and asymptomatic. Giant variants are uncommon and may mimic cervical fibroids or malignancy when they present as large prolapsing masses. Case presentation: A 36-year-old Para 1+1 woman presented with a 2-year history of a progressively enlarging mass per vaginam, abnormal uterine bleeding and offensive vaginal discharge. Examination showed a dark, malodorous, partially cystic, reducible polypoid mass measuring approximately 10 × 5 cm, attached by a long pedicle to the anterior cervical lip. Pelvic ultrasonography excluded uterine and adnexal masses but did not definitively characterise the cervical lesion. The mass was completely excised under subarachnoid block with a 1-cm cuff of cervical tissue and treated with peri-operative broad-spectrum antibiotics. Histopathology confirmed an acutely infected suppurative Nabothian cyst without atypia, dysplasia or malignancy. Recovery was uncomplicated, and symptoms had resolved at four-week follow-up. Conclusion: Giant infected Nabothian cysts may mimic cervical fibroids, polyps and malignancy. Histopathological examination of excised cervical tissue is essential for definitive diagnosis. Short-term outcome after conservative excision was favourable in this patient, although longer follow-up is required to assess recurrence.