Paraovarian / Paratubal Cyst

Definition

Paraovarian / paratubal cysts are epithelium-lined fluid-filled cysts in the adnexa adjacent to the fallopian tube and ovary. The terms are used interchangeably depending on the location of the cyst.

Epidemiology

Although their exact incidence cannot be known due to their typically asymptomatic nature, paraovarian cysts may account for 5-20% of all adnexal masses and are found in about 15% of laparoscopies.

Aetiopathogenesis

Paraovarian cysts develop either from the mesothelium of the broad ligament (68%) or from paramesonephric (30%) or mesonephric remnants (2%).

Clinical Image

Typically asymptomatic. Complications may include:

  • Cyst enlargement (common, yet gigantic cysts with pressure symptoms e.g. hydronephrosis are rare)
  • Torsion (not uncommon, especially in younger patients)
  • Rupture (uncommon)
  • Haemorrhage (uncommon)
  • Neoplasm (extremely rare)
parovarian paratubal cyst
Parovarian cyst. Above: the cyst is measured in two perpendicular planes. Below the same images, where the paraovarian cyst has been colored to emphasize. A little free peritoneal fluid is seen.

Diagnostics

Ultrasound is the top diagnostic tool to identify a paraovarian cyst. The following finding is pathognomonic:

Anechoic, unilateral, thin-walled, mobile cyst which can be separated from the ovary (and tube, if visible) on palpation.

Management

  • If found on ultrasound and small in size, control examination is suggested.
  • If found during surgical intervention (laparoscopy, cesarean section etc.) careful surgical removal is suggested – the ovarian and tubal blood supply must not be disrupted.
  • In case of symptoms, surgical removal is indicated.
  • In case of suspected malignancy, surgical removal in one piece is important.
A large parovarian cyst mimicking an ovarian cyst.

Bibliography

  • Durairaj, A., & Gandhiraman, K. (2019). Complications and Management of Paraovarian Cyst: A Retrospective Analysis. Journal of obstetrics and gynaecology of India69(2), 180–184. https://doi.org/10.1007/s13224-018-1152-2
  • Alaoui, F. Z., El Fatemi, H., Chaara, H., Melhouf, M. A., & Amarti, A. (2012). Borderline paratubal cyst: a case report. The Pan African medical journal13, 53.
  • Leanza, V., Coco, L., Genovese, F., Pafumi, C., Ciotta, L., Leanza, G., Zanghì, G., Intagliata, E., & Vecchio, R. (2013). Laparoscopic removal of a giant paratubal cyst complicated by hydronephrosis. Il Giornale di chirurgia34(11-12), 323–325.
Similar topics:

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.