Abstract
Background: Paraovarian cysts are benign cysts that develop near the ovaries and fallopian tubes in the pelvic region. They can cause mass effects requiring excision. In rare cases, tumors may develop inside these cysts. These tumors may be benign, malignant, or borderline. Case Report: A 26-year-old lady presented for excision of a paraovarian cyst. Pre-operative imaging showed the presence of few undulating folds at the periphery of the cyst. The patient underwent laparoscopic pelvic cystectomy without intra-operative drainage. Pathological examination of the specimen revealed a borderline serous papillary tumor protruding from the cyst wall. Conclusion: The occurrence of a borderline tumor, also known as a tumor of low malignant potential, in a pre-existing paraovarian cyst is very rare and has only been reported few times in the literature. A thorough review of these cases showed that the most common imaging finding that raises suspicion for a borderline tumor within a paraovarian cyst is the presence of small intracystic projections within the unilocular adnexal cyst. However, since evaluating the presence of an intracystic tumor is not always possible, performing a fertility-preserving laparoscopic cystectomy without cyst content spillage, is recommended. If properly excised, the prognosis of this tumor is good, and recurrence is rare.
Highlights
Paraovarian cysts, called paratubal cysts, are simple cysts arising near the ovary or the fallopian tube [1]
A thorough review of these cases showed that the most common imaging finding that raises suspicion for a borderline tumor within a paraovarian cyst is the presence of small intracystic projections within the unilocular adnexal cyst
Borderline papillary tumor arising in paraovarian cyst is a rare condition reported only 18 times in the literature
Summary
Borderline papillary tumor arising in paraovarian cyst is a rare condition reported only 18 times in the literature. Cyst diagnosis ranged from being an incidental finding to presenting with an acute pain episode suggestive of adnexal torsion in other cases. The most common imaging finding suggesting a borderline tumor within a paraovarian cyst was the presence of a unilocular adnexal cyst with small intracystic projections. More invasive staging procedures such as bilateral salpingo-oophorectomy, hysterectomy, peritoneal biopsies, and paraaortic lymph node dissection are not usually necessary for typical cases of unilocular paraovarian cyst with borderline serous tumor. Recurrence of such tumors after excision was found to be very rare and reported only once in the literature.
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