Vaginal müllerian cyst: An unusual cause of vaginal bleeding in a 16-month-old girl

Background: Vaginal bleeding in premenarchal girls is always abnormal and its source must be identified for appropriate management. Examination under anesthesia and vaginoscopy are commonly employed for evaluation of the vagina as a source of bleeding, and the examination may occasionally reveal vaginal pathology. Case: A 16-month-old otherwise healthy girl presented with spotting. Exam under general anesthesia and vaginoscopy revealed a 1-cm polypoid-like lesion overlying the posterior vaginal wall which was excised using the hysteroscope. Pathology revealed a benign Müllerian cyst. Summary and Conclusion: Vaginal findings of causes of premenarchal bleeding such as Mullerian cysts may be diagnosed and treated with the vaginoscopic approach.