Paraovarian Cyst

What is Paraovarian Cyst?

The Paraovarian cyst is a closed sac filled with fluid that grows adjacent to the ovary. The cyst might grow deeper inside the ligament surrounding the ovary and the follicle tube but is not attached to them. It is commonly found on one side of the uterus and usually located between the uterus and ovary.

It is believed to be developed from the embryological vestiges (Wolffian structures) which are the external covering of the follicular tube (tubal epithelium) or from the serous membrane that lines the abdominal cavity (peritoneum).

History and Etymology

The Paraovarian cyst is also known as:

  • Paratubal cyst
  • Hydatid cyst of Morgagni.

Pathology

They occur around the broad ligament and come from the remnants of paramesonephric, mesonephric or mesothelial. Paraovarian cystadenomas come under the Paraovarian cyst but is a simple cyst.

Causes & Risk Factors 

Often they cannot be distinguished from the simple ovarian cyst and is common in women aged between 20-40 years. At the time of pregnancy, sizeable Paraovarian cyst tends to develop and overgrow.

Symptoms of Paraovarian Cyst

The only symptom is aching pain and dull gnawing in the lower part of the abdomen. The pain is due to the development of cyst in the ligaments that stretch the tissue. On most occasions, people suffering from this issue believe that they have a problem with kidney or spinal cord.

Diagnosis

  • Ultrasound
  • Laparoscopy (visual examination)

Complications

  • Infection
  • Bleeding
  • Rupture of the cyst
  • Cystic internal bleeding (intracystic hemorrhage)
  • Formation & disruption of pus

In case of pregnant women, the uterus enlarges and pushes out on the opposite side of the pelvic region and this may lead to:

  • Overestimation of the period of gestation
  • Abnormal intrauterine fetal positioning
  • Difficulty during delivery
  • Life-threatening complications for mother
  • Rupture of the cyst
  • Intrauterine fetal death

Treatment

Paraovarian cysts that are small and asymptomatic can dissolve on their own. However, treatment is required for girls who have not reached the stage of puberty, menopausal women and those who have ovarian mass. The treatment should start with anti-inflammatory therapy, but if the cyst is more than 4 inches in size and has the following problems, then invasive surgery (cystectomy) is required.

  • Dense & solid
  • Irregular shaped
  • Infected
  • Ruptured or bleeding

If the cyst is removed surgically, then it is imperative not to damage the follicular tube because it may lead to severe problems with pregnancy such as ectopic pregnancy or infertility.

Prognosis

Complete recovery after the surgery is possible if the woman is not pregnant and chances of recurrence are less. During pregnancy, complete recovery is possible if the removal of the cyst is performed within 14 to 20 weeks of gestation.

References

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