Mary Tong, BHSc, MD Candidate, McMaster University, Hamilton, ON.
Joseph M. Lam, MD, FRCSC, Clinical Associate Professor, Department of Pediatrics, Clinical Associate Professor, Department of Dermatology University of British Columbia, BC.

Abstract
Median raphe cysts are rare congenital lesions caused by a defect in embryological development of the male genitalia. They can present as solitary or multiple papules along the median raphe from urethral meatus to the anus. Although they are asymptomatic during childhood, they can cause problems later on as they increase in size. Surgical excision of the lesion is not necessary unless the patient becomes symptomatic.
Key Words: median raphe cysts, congenital lesions, treatment, management.

Case Presentation

A 14 ½-month-old boy presented with a history of several white papules in the midline of the scrotum and ventral surface of the penis noticed from 3 months of age and possibly since birth. Other than a NICU stay for prematurity and an egg white allergy, he was healthy. Physical examination revealed several white-yellow papules on the midline of his scrotum, and one lesion on the base of his penis [Figure 1]. He had no hypospadias, and no other midline lesions were noted. Based on the site and appearance of the lesions, a diagnosis of median raphe cysts was made.