paraovarian cysts

Paraovarian cysts account for 10-20% of all adnexal masses and are relatively uncommon in children. They are more common in women 30 to 40 years of age.

Paraovarian cysts arise from the tissues of the broad ligament, predominantly from mesothelium covering the peritoneum (mesothelial cysts) but also from paramesonephric (paramesonephric cysts or Mullerian cyst) and rarely mesonephric remnants (mesonephric cyst or Wolffian cyst).

They are usually incidentally discovered during surgery and prophylactic excision is performed due to the increased incidence of torsion as well as their propensity to undergo rapid enlargement.

Types

 paramesonephric cyst
 hydatid cyst of Morgagni
 Wolffian cyst
 Kobelt cyst
 cyst of the organ of Rosenmuller

Paramesonephric cysts

The paramesonephric duct (or Mullerian duct) forms the fallopian tube at about 9 weeks of gestation. Multiple invaginations near the ostium of the tube become the fimbriae. Any secondary invagination that does not connect may form a blind sac and enlarge to form a paraovanan cyst.

Complications

 paraovarian cyst torsion (2-16%)
 hemorrhage
 rupture
 secondary infection
 neoplasatic transformation (2.9%)

• papillary serous cystadenoma
• endometrioid cystadenocarcinoma
• serous cystadenocarcinoma
• mucinous cystadenocarcinoma

Torsion of the paraovarian cyst is three times more common in pregnant women likely related to rapid growth spurt.

See also

 Cysts

• pelvic cysts
• paratubal cysts

References

 Paraovarian/paratubal cysts: comparison of transvaginal sonographic and pathological findings to establish diagnostic criteria. Savelli L, Ghi T, De Iaco P, Ceccaroni M, Venturoli S, Cacciatore B. Ultrasound Obstet Gynecol. 2006 Sep;28(3):330-4. PMID: 16823765

 Development and classification of parovarian cysts. An ultrastructural study. Stenbäck F, Kauppila A. Gynecol Obstet Invest. 1981;12(1):1-10. PMID: 7250778

 Serous papillary neoplasms arising in paramesonephric parovarian cysts. A report of eight cases. Honoré LH, O’Hara KE. Acta Obstet Gynecol Scand. 1980;59(6):525-8. PMID: 7457096