Suprapubic cartilaginous cysts (SPCC) are rare cystic lesions arising from the symphysis pubis thought to be degenerative in origin. They have also been called retropubic or subpubic cysts.
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Epidemiology
In the small number of cases in the literature, all bar one patient, have been female. The majority were multiparous and post-menopausal.
Clinical presentation
Asymptomatic or causes pelvic pain, urinary voiding symptoms, a vulvar mass, or even dyspareunia.
Pathology
The cyst contains mucinous degenerative contents within a fibrocartilaginous capsule.
Radiographic features
Ultrasound
Cystic structure usually posterosuperior to the symphysis pubis.
CT
Exophytic cystic structure arising from the symphysis pubis usually located anterior to the urinary bladder; it can contain small foci of nitrogen gas from the degenerative fibrocartilaginous disc of symphysis pubis (as part of the vacuum phenomenon of degenerative joint disease).
MRI
Fluid signal (i.e. low T1W and high T2W signal) of the contents with an enhancing thin wall post-contrast administration.
Treatment and prognosis
Surgical resection has been employed successfully in symptomatic patients. Aspiration and steroid injections have also been tried.
History and etymology
Suprapubic cartilaginous cysts were first described in 1996 by two pathologists at the University of Manitoba, Antonio Alguacil-Garcia and Charles Littman 4.
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