Histology: The cysts are lined with a pseudostratified or stratified columnar epithelium. The epithelium can closely approximate the appearance of transitional urethral cell epithelium. The lining surrounds a central cavity filled with serous fluid. Large mucinous cells are scattered throughout the columnar epithelium. The luminal cells have been shown to stain with cytokeratin 7, cytokeratin 13, epithelial membrane antigen (EMA), and carcinoembryonic antigen (CEA). Histologically, these cysts have a very characteristic appearance. The main pathological differential diagnosis is between the median raphe cyst and an apocrine cystadenoma. Immunohistochemical staining can be used to differentiate the two.
Treatment: Simple surgical excision is all that is required for cure. They will not recur, because they are developmental cysts. Care should be taken not to damage underlying structures, and often a urological surgeon performs the procedure.
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