Paraovarian cysts orparatubal cysts areepithelium-lined fluid-filledcysts in theadnexa adjacent to thefallopian tube andovary. The terms are used interchangeably,[1] and depend on the location of the cyst.[2]
On histopathology, paraovarian cysts are generally lined by simple cuboidal epithelium as shown. However, they may have fallopian tubal epithelium or focal papillary projections.[2]
Most cysts are small and asymptomatic.[1] Typical sizes reported are 1 to 8 cm in diameter.[1] PTCs may be found at surgery or during an imaging examination that is performed for another reason. Larger lesions may reach 20 or more cm in diameter and become symptomatic exerting pressure and pain symptoms in the lower abdomen.[3] Large cysts can lead totorsion of the adnexa inflicting acute pain.[3][4]
Prior to surgery, PTCs are usually seen onultrasonography. However, because of the proximity of the ovary that may display follicle cysts, it may be a challenge to identify a cyst as paratubal or paraovarian.[5]
Smaller lesions can be followed expectantly. Larger lesions, lesions that are growing or symptomatic, and lesions with sonographically suspicious findings (septation, papillations, fluid and solid components) are generally surgically explored and removed.[citation needed]
PTCs have been reported in all female age groups and seem to be most common in the third to fifth decades of life.[1][7] A study in Italy estimated their incidence to be about 3%,[1] while an autopsy study of postmenopausal women detected them in about 4% of cases.[8]These cysts constitute about 10% of adnexal masses.[5]
Hydatid cysts of Morgagni, alsohydatids of Morgagni orMorgagni's cysts, are common and appear as pedunculated, often tiny, frequently multiple cysts connected to the fimbriae of the fallopian tubes. They thus appear to be a specific variant of paratubal cysts.[9] They are named afterGiovanni Battista Morgagni.
While usually asymptomatic, it has been noted that these cysts tend to be more common in women withunexplained infertility (52.1% versus 25.6% in controls, p<0.001) and suggested that they may play a role in infertility.[10] It has been proposed that these cysts interfere with tubal pick-up and function.[11][12]
^abcdefKiseli M, Caglar GS, Cengiz SD, Karadag D, Yilmaz MB (2012). "Clinical diagnosis and complications of paratubal cysts: Review of the literature and report of uncommon cases".Arch Gynecol Obstet.285 (6):1563–69.doi:10.1007/s00404-012-2304-8.PMID22526447.S2CID5638006.
^abVarras M, Akrivis C, Polyzos D, Frakala S, Samara C (2003). "A voluminous twisted paraovarian cyst in a 74-year-old patient: case report and review of the literature".Clin Exp Obstet Gynecol.30 (4):253–6.PMID14664426.
^Thakore SS, Chun MJ, Fitzpatrick K (2012). "Recurrent ovarian torsion due to paratubal cysts in an adolescent female".J Pediatr Adolesc Gynecol.25 (4):85–7.doi:10.1016/j.jpag.2011.10.012.PMID22840942.
^Suzuki S, Furukawa H, Kyozuka H, Watanabe T, Takahashi H, Fujimori K (2013). "Two cases of paraovarian tumor of borderline malignancy".Journal of Obstetrics and Gynaecology Research.39 (1):437–41.doi:10.1111/j.1447-0756.2012.01953.x.PMID22889349.S2CID205512035.
^Damle F, Gomez-Lobo V (2012). "Giant paraovarian cysts in young adolescants: a report of three cases".J Reprod Med.57 (1–2):65–7.PMID22324272.
^Dorum A, Blom GP, Ekerhovd E, Granberg S (2005). "Prevalence and histologic of adnexal cysts in postmenopausal women: an autopsy study".Am J Obstet Gynecol.192 (1):48–54.doi:10.1016/j.ajog.2004.07.038.PMID15672002.
^Hoffman, Barbara (2012).Williams gynecology. New York: McGraw-Hill Medical. p. 272.ISBN9780071716727.
^Rasheed SM, Abdelmonem AM (2011). "Hydatid of Morgagni: a possible underestimated cause of unexplained infertility".Eur J Obstet Gynecol Reprod Biol.158 (1):62–6.doi:10.1016/j.ejogrb.2011.04.018.PMID21620555.
