The Bartholin Cyst that Wasn’t: A Case Report of Metastatic Cancer

Endometrial cancer is the most common gynecologic cancer in economically developed countries, and the second most common gynecologic cancer in economically developing countries [2]. Women in the United States have a 2.6% lifetime risk of developing uterine cancer, with the average age of diagnosis being 61 years old [2]. Eighty to ninety percent of the time, abnormal vaginal bleeding or discharge is the primary chief complaint [3]. At the time of diagnosis, the risk of the patient having distant metastases is approximately 8% [4]. Common sites of metastases from uterine cancer are the lungs, liver, inguinal and supraclavicular nodes, bones, brain, and vagina [5]. With regards to alternate sites of metastasis, the Bartholin glands are a rare target, with few case reports published of their existence. Primary cancers of the Bartholin gland, however, have been described, with many case reports detailing them and their potential for metastases to the liver, lungs, and even the brain. We present a case of a perimenopausal woman who initially presented with a left vaginal lesion and irregular menses that was later found to have a poorly differentiated carcinoma in both the Bartholin gland and endometrium. Histology and imaging later determined the endometrium to be the primary source of the malignancy.