Male median raphe cysts: serial retrospective analysis and histopathological classification

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.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.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.The virtual slide(s) for this article can be found here: http//http://www.diagnosticpathology.diagnomx.eu/vs/7727074877500751 webciteMedian raphe cysts can develop at any site along the midline of the ventral side of the male genital area, from the meatus to the scrotum and perineum (Figure 1). In most patients, the cysts, which are asymptomatic or unrecognized during childhood, may progress later and become symptomatic during adolescence or adulthood. Although these cysts were first identified decades ago, only a few have been reported to date, mostly in case reports. The clinic pathological characteristics and pathogenesis of the disease are not well understood by physicians. In this study, we reviewed the medical records of patients with median raphe cysts to analyze the clinical characteristics and classify the histopathological finding