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Open Access Highly Accessed Research

Male median raphe cysts: serial retrospective analysis and histopathological classification

I-Hung Shao1, Tai-Di Chen2, Hsiang-Te Shao3 and Hsiao-Wen Chen1*

Author Affiliations

1 Division of Urology, Department of Surgery, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.5, Fusing St., Gueishan Township, Taoyuan County, 333, Taiwan

2 Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.5, Fusing St., Gueishan Township, Taoyuan County, 333, Taiwan

3 Division of Dermatology, Department of Internal Medicine, Taipei City Hospital, Renai Branch, No.145, Zhengzhou Rd., Datong Dist., Taipei City, 103, Taiwan

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Diagnostic Pathology 2012, 7:121  doi:10.1186/1746-1596-7-121

Published: 14 September 2012

Abstract

Background

To review the clinical and pathological characteristics of median raphe cysts and to classify the lesions according to pathogenesis and histopathological findings.

Methods

The medical records of patients who were diagnosed with median raphe cysts between 2001 and 2010 were reviewed to document the clinical presentation and pathological findings of the cysts.

Results

Most patients were asymptomatic; however, 9 patients had inflammatory or infectious cysts that were tender or painful. Four patients who had cysts on the parameatus and distal prepuce had difficulty voiding. Hematuria and hematospermia were noted in 2 cases. Thirty-one cysts were lined with an urothelium-like epithelium, and a squamous epithelium lining was found in 3 cases. In 2 cases, a well-formed mucinous glandular structure was observed. The other 20 cysts consisted of mixed epithelia. After excision of the cysts under local or general anesthesia, an urethral fistula developed as a complication in only 1 case.

Conclusions

Median raphe cysts are benign lesions formed due to tissue trapping during the development of urethral folds. The cysts can be defined into 4 types based on pathological findings: urethral, epidermoid, glandular, and mixed. The associated symptoms and signs should be taken into consideration when determining the treatment for the cysts.

Virtual slides

The virtual slide(s) for this article can be found here: http//http://www.diagnosticpathology.diagnomx.eu/vs/7727074877500751 webcite

Keywords:
Median raphe cyst; Paraurethral cyst; Male genitalia cyst; Penile cyst; Genitoperineal cysts; Pathological classification