A narrative review on the practice of genital mutilation among Arab adolescent females and a case report on a large clitoral epidermal inclusion cyst

Female circumcision, also known as female genital mutilation/cutting (FGM/C), is a common practice in many Arab countries, including Egypt. One potential complication of FGM/C is the development of a clitoral epidermal inclusion cyst, which occurs when keratinized epithelial cells and sebaceous glands become incorporated into the circumcision scar line in the clitoral or labial area. The objective of this study is to present a rare case of a large clitoral epidermal inclusion cyst following FGM/C and to review the current practice of FGM/C in the Arab world, including Egypt, Sudan, and Saudi Arabia. A retrospective review of medical records for a single rare case and a literature search on PubMed were conducted to gather information on FGM/C in Egypt and the Arab region. A newly married 19-year-old Egyptian adolescent female presented with a large (∼5 × 5 cm) painless clitoral swelling, 11 years after undergoing FGM/C. A complete history, perineal examination, and ultrasonography suggested a clitoral swelling, with the top differential diagnosis being an “epidermal inclusion cyst”. During surgery, a cystic swelling was dissected and enucleated with the capsule intact. Histopathology of the specimen confirmed the presence of an epidermal inclusion cyst, most likely related to the previous FGM/C during her childhood. Clitoral epidermal inclusion cysts can arise many years after FGM/C. Surgical intervention is successful in treating this rare and longterm post-circumcision complication. The practice of FGM/C remains prevalent among adolescent females in Egypt and many other Arab countries. •Female circumcision or female genital mutilation/cutting (FGM/C) is practiced in many Arab countries, including Egypt and Saudi Arabia. Many short and long-term potential harms this tradition could have on the circumcised females.•This narrative review and case report should raise awareness of a common practice among adolescent females in many Arab countries and such a relatively rare delayed complication of FGM/C and attract attention to the prevalent existence of FGM/C at a national level in these countries.•We report a case of a newly married adolescent Egyptian patient (19 years) with a large painless clitoral swelling, presented 11 years after prior FGM/C. After excision, the histopatology showed an epidermal inclusion cyst mostly related to the previous FGM/C during her childhood.•Also, we referred to the current practice of FGM/C and reporting of similar cases in Eg