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A Gartner Duct Cyst Masquerading as Anterior Vaginal Prolapse. BACKGROUND: Gartner duct cysts are embryologic remnants of the mesonephric ducts that may present as a vaginal mass or cyst. CASE: A patient was referred for surgical management of prolapse whose bulging anterior vagina was actually a Gartner duct cyst that required excision as a result of symptoms. Preoperative magnetic resonance imaging helped confirm the diagnosis. CONCLUSION: A Gartner duct cyst may present as a vaginal cyst that, if large, may mimic pelvic organ prolapse. The diagnosis should be considered when a patient's individual prolapse compartments are inconsistent or when physical examination is suggestive of another process.