Clitoral epidermal cyst after excision in an 8-year-old girl: the pivotal role of forensic medicine in the detection and care of female genital mutilation (FGM)-related complications.
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BACKGROUND: Female genital mutilation (FGM) refers to socio-cultural practices involving the partial or total removal of a woman's external genitalia for non-medical purposes. These procedures are associated with numerous short- and long-term physical and psychological complications. While such complications are relatively well documented in adults, pediatric cases remain insufficiently reported. Forensic physicians are often the first - and sometimes the only - healthcare providers to detect and document these complications, particularly in asylum contexts. CASE PRESENTATION: We report the case of an 8½-year-old Guinean girl with a history of type IIb FGM, examined by a forensic physician during an asylum application. The medico-legal examination revealed a 3 cm mobile mass at the clitoral site, causing pelvic pain and urinary dysfunction. Her father had allegedly threatened to perform a second excision. Protective measures were implemented in coordination with child welfare authorities before surgical intervention, which resulted in complete resection of the clitoral mass. Histopathology confirmed the diagnosis of an epidermoid cyst. CONCLUSIONS: This case underscores the critical role of forensic physicians in identifying rare pediatric complications of FGM and initiating both protective and therapeutic interventions. By enabling surgical treatment and preventing long-term psychological harm, it highlights the integrative function of forensic medicine at the intersection of health, law, and child protection.