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Pathology of Median Raphe Cyst

Dr Sampurna Roy MD         

Dermatopathology Case 108

Diagnosis: Median Raphe Cyst




Median raphe cyst is a very rare, benign congenital lesion occurring mainly on the ventral aspect of the penis, but can develop anywhere in the midline between the external urethral meatus and anus.

It is most common near the glans penis.

They are thought to arise as a result of defective embryological closure of the median raphe, but some may result from the anomalous outgrowth of the entodermal urethral lining (urethroid cyst).

Median raphe cyst may be formed as a result of local trauma or secondary infection.

Gross presentation: 

These cysts are usually less than 1 cm in diameter.

The contents are usually clear, but they may be turbid if there is abundant mucous glands in the wall.


Median raphe cysts are usually located in the dermis.

These lesions do not connect with the overlying surface epithelium.

The cysts are lined by pseudostratified columnar epithelium.

In some areas they may be quite attenuated.

Occasionally, mucous glands are present in the wall, but ciliated cells are rare.

Pigmented cysts, resulting from the presence of melanocytes, have been reported.

In cysts situated near the meatus, the lining is usually stratified squamous epithelium.


Further reading:

Pigmented median raphe cyst of the penis with consideration of the possible mechanism of melanocytic colonization: A case report.

Male median raphe cysts: serial retrospective analysis and histopathological classification.

Pigmented median raphe cyst of the penis.

Median raphe cysts of the prepucial skin, with triple histological linings: a case report and review of the literature.

Canal-like median raphe cysts: an unusual presentation of an unusual condition.

Median raphe cyst. Report of two cases and literature review.

Median raphe cysts of the perineum in children.

Ciliated median raphe cyst of perineum presenting as perianal polyp: a case report with immunohistochemical study, review of literature, and pathogenesis.

Immunohistochemical characterization of a median raphe cyst of the penis.




Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






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