<prompt> A 58-year-old woman is seen for evaluation of a swelling in her right vulva. She has also noted pain in this area when walking and during coitus. At the time of pelvic examination, a mildly tender, fluctuant mass is noted just outside the introitus in the right vulva in the region of the Bartholins gland. What is the most appropriate treatment?MarsupializationAdministration of antibioticsSurgical excisionIncision and drainage  <response>: Although rare, adenocarcinoma of the Bartholins gland must be excluded in women over 40 years of age who present with a cystic or solid mass in this area. The appropriate treatment in these cases is surgical excision of the Bartholins gland to allow for a careful pathologic examination. In cases of abscess formation, both marsupialization of the sac and incision with drainage as well as appropriate antibiotics are accepted modes of therapy. In the case of the asymptomatic Bartholins cyst, no treatment is necessary. 