Paraovarian cysts or paratubal cysts are

epithelium Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellul ...

-lined fluid-filled

cyst A cyst is a closed sac, having a distinct envelope and cell division, division compared with the nearby Biological tissue, tissue. Hence, it is a cluster of Cell (biology), cells that have grouped together to form a sac (like the manner in which ...

s in the adnexa adjacent to the

fallopian tube The fallopian tubes, also known as uterine tubes, oviducts or salpinges (singular salpinx), are paired tubes in the human female that stretch from the uterus to the ovaries. The fallopian tubes are part of the female reproductive system. In ot ...

and

ovary The ovary is an organ in the female reproductive system that produces an ovum. When released, this travels down the fallopian tube into the uterus, where it may become fertilized by a sperm. There is an ovary () found on each side of the body. ...

. The terms are used interchangeably, and depend on the location of the cyst. Topic Completed: 1 July 2013. Minor changes: 30 December 2020

Pathophysiology

PTCs originate from the

mesothelium The mesothelium is a membrane composed of simple squamous epithelial cells of mesodermal origin, which forms the lining of several body cavities: the pleura (pleural cavity around the lungs), peritoneum (abdominopelvic cavity including the mesente ...

and are presumed to be remnants of the

Müllerian duct Paramesonephric ducts (or Müllerian ducts) are paired ducts of the embryo that run down the lateral sides of the genital ridge and terminate at the sinus tubercle in the primitive urogenital sinus. In the female, they will develop to form the fal ...

and

Wolffian duct The mesonephric duct (also known as the Wolffian duct, archinephric duct, Leydig's duct or nephric duct) is a paired organ that forms during the embryonic development of humans and other mammals and gives rise to male reproductive organs. Stru ...

Diagnosis

Most cysts are small and asymptomatic. Typical sizes reported are 1 to 8 cm in diameter. 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. Large cysts can lead to

torsion Torsion may refer to: Science * Torsion (mechanics), the twisting of an object due to an applied torque * Torsion of spacetime, the field used in Einstein–Cartan theory and ** Alternatives to general relativity * Torsion angle, in chemistry Bi ...

of the adnexa inflicting acute pain. Prior to surgery, PTCs are usually seen on

ultrasonography Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies fr ...

. 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.

Malignancy

PTCs are generally benign, but may, on rare occasions, give rise to

borderline tumor A borderline tumor, sometimes called low malignant potential (LMP) tumor, is a distinct but yet heterogeneous group of tumors defined by their histopathology as atypical epithelial proliferation without stromal invasion. This topic last updated: Fe ...

s and malignancies.

Management

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.

Epidemiology

PTCs have been reported in all female age groups and seem to be most common in the third to fifth decades of life. A study in Italy estimated their incidence to be about 3%, while an autopsy study of postmenopausal women detected them in about 4% of cases. These cysts constitute about 10% of adnexal masses.

Hydatid cysts of Morgagni

Hydatid cysts of Morgagni, also hydatids of Morgagni or Morgagni'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. They are named after

Giovanni Battista Morgagni Giovanni Battista Morgagni (25 February 1682 – 6 December 1771) was an Italian anatomist, generally regarded as the father of modern anatomical pathology, who taught thousands of medical students from many countries during his 56 years as Prof ...

. While usually asymptomatic, it has been noted that these cysts tend to be more common in women with

unexplained infertility Unexplained infertility is infertility that is idiopathic in the sense that its cause remains unknown even after an infertility work-up, usually including semen analysis in the man and assessment of ovulation and fallopian tubes in the woman.merck ...

(52.1% versus 25.6% in controls, p<0.001) and suggested that they may play a role in infertility. It has been proposed that these cysts interfere with tubal pick-up and function.

References

External links

{{Medical resources , DiseasesDB = , ICD10 = {{ICD10, N, 83, 8, } , ICD9 = {{ICD9, 752.11 , ICDO = , OMIM = , MedlinePlus = , eMedicineSubj = , eMedicineTopic = , MeshID = Noninflammatory disorders of female genital tract