Peer-reviewed article
Clitoral epidermal cyst after excision in an 8-year-old girl: the pivotal role of forensic medicine in the detection and care of female genital mutilation (FGM)-related complications.
Du Fayet de la Tour A, Ballouhey Q, Raguin P, Paraf F ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This case report describes an 8-year-old girl from Guinea who developed a clitoral cyst as a complication of female genital mutilation (FGM) that she had undergone. A forensic physician identified the cyst during an asylum application examination and discovered the girl was at risk of a second excision from her father. With protective measures in place, the girl underwent surgery to remove the cyst. The report emphasizes the important role forensic doctors play in detecting FGM complications in children and coordinating protection and treatment.
Key points
- An 8-year-old girl presented with a 3 cm clitoral epidermoid cyst following type IIb FGM
- The cyst caused pelvic pain and urinary dysfunction
- The girl's father had threatened to perform a second excision
- A forensic physician's examination during an asylum application led to identification of the complication and protective intervention
- Surgical resection of the cyst was completed and histopathology confirmed epidermoid cyst diagnosis
Limitations
This is a single case report that documents one child's experience; it cannot tell us how common this specific complication is, what proportion of FGM-affected children develop such cysts, or whether outcomes differ across different clinical or social contexts.
Abstract
Background Female genital mutilation (FGM) refers to socio-cultural practices involving the partial or total removal of a woman's external genitalia for non-medical purposes. These procedures are associated with numerous short- and long-term physical and psychological complications. While such complications are relatively well documented in adults, pediatric cases remain insufficiently reported. Forensic physicians are often the first - and sometimes the only - healthcare providers to detect and document these complications, particularly in asylum contexts. Case presentation We report the case of an 8½-year-old Guinean girl with a history of type IIb FGM, examined by a forensic physician during an asylum application. The medico-legal examination revealed a 3 cm mobile mass at the clitoral site, causing pelvic pain and urinary dysfunction. Her father had allegedly threatened to perform a second excision. Protective measures were implemented in coordination with child welfare authorities before surgical intervention, which resulted in complete resection of the clitoral mass. Histopathology confirmed the diagnosis of an epidermoid cyst. Conclusions This case underscores the critical role of forensic physicians in identifying rare pediatric complications of FGM and initiating both protective and therapeutic interventions. By enabling surgical treatment and preventing long-term psychological harm, it highlights the integrative function of forensic medicine at the intersection of health, law, and child protection.