Paraovarian Cyst Research Articles

Histopathological study of surgically resected specimens of fallopian tube

Background: Fallopian Tubes are very common surgical specimen received in the pathological laboratory. It is affected by wide spectrum of both non neoplastic and neoplastic lesions. But there is very few studies described the frequency of various histopathological spectrums of lesions of fallopian tube. Aims & Objectives: To study the various histopathological lesions seen in surgically resected specimens of fallopian tube and their age distributions.Material and Method: A total of 200 surgically resected specimen of fallopian tube of all age group of patients which are received for one and half year duration, are processed with routine histopathological techniques. Histopathological features were studied on Haematoxylin and Eosin stain.Results: In our studies majority of the cases are belongs to 40 to 60 years of age out of 200 specimens. In this study, most of the patients were undergone total abdominal hysterectomy with salpingo-oophorectomy (60%). In our study out of 200 cases 63 (31.50%) specimens show unremarkable histology. Only 1(0.50%) case shows neoplastic pathology. Most common histopathological findings observed are paratubal cyst, ectopic tubal gestation and Walthard Cell Nests.Conclusion: Present study shows broad spectrum of pathological lesions in fallopian tube. Majority of the lesions are non neoplastic in nature. Thorough histopathological examination of fallopian tube specimens is necessary to document many lesions including rare primary intraepithelial malignancy which can be missed clinically and found incidentally on histopathological examination.

103. Paratubal Cyst Recurrence in Children and Adolescents

A paratubal/paraovarian cyst (PTC) is an encapsulated, fluid-filled sac near the ovary or fallopian tube. They may be found incidentally or acutely due to adnexal torsion. Currently, there is little data to guide patient counseling regarding recurrence risk of these cysts. The goal of this study was to determine if there are pathologic or patient characteristics that correlate with increased recurrence risk.

Paraovarian cyst as the cause of uterine prolapse

Paraovarian cysts originate from the mesothelium and are presumed to be remnants of M?llerian or Wolffian ducts. In majority of cases they are found to be 10-80 mm in diameter and do not cause any symptoms. Paraovarian cysts can be found unexpectedly during an operation or on ultrasound examination performed for other reasons. They are most freequently discovered on ultrasound examination. However, due to the proximity of the ovary for which cystic formations are not rare, the diagnosis of these lesions can be a challenge. They are mostly asymptomatic and only large lesions (?20 cm in diameter) become symptomatic. Although these are mostly benign tumors, in rare cases they can become borderline or true malignancies. Most paraovarian cysts are found in the third and fourth decade of life. Paraovarian cyst complications include: compression of the surrounding structures of the pelvis minor and abdomen, pelvic pain, cyst torsion and rupture. Except for the already mensioned complications available literature has so far failed to show cases of uterine prolapse caused by an increase of intra-abdominal pressure due to the expansive growth of giant paraovarian cystic formation.

Female reproductive potential after oncological treatment: a rare case report of acute myeloid leukemia in monozygotic twin sisters with literature review

BackgroundAcute myeloid leukemia (AML) in monozygotic twins is a rare event and, until now, only a few cases have been reported. Due to improved oncological treatment and cancer survival rates, quality of life considerations post-treatment have become an important aspect in the treatment regime. The ability to have their own biological children is considered one of the most important indicators of quality of life by cancer survivors. As fertility following oncological treatment is often impaired, fertility preservation methods should be offered to these patients prior to the treatment. Here, we present a very rare case in which we can in vivo observe the impact of oncological treatment on female fertility when applied before and after puberty.Case presentationThis is a very rare case of concordant AML in monozygotic twin sisters. Twin A became sick at the age of 21 months. She was treated with cytostatic medications and then underwent bone marrow transplantation (BMT), the donor being her twin sister B. After 27 years, she is disease free and has regular periods. After trying to conceive for 4 years, she was seen by an infertility specialist. She underwent hysteroscopic uterine septum removal and laparoscopic enucleation of bilateral paraovarian cysts. Following those procedures, she immediately conceived naturally. Twin B became sick at 15 years of age. She was treated with chemotherapy and cranial radiation and relapsed after 10 years. She then received chemotherapy and had a BMT. Until relapse, she had normal menstrual cycles. After the second treatment she became amenorrhoeic and is now part of an oocyte donation program.ConclusionsThis is a case of AML in monozygotic twins who, after treatment, have completely different reproductive potential. They both received oncological treatment, and one of them conceived conceived naturally while the other suffered premature ovarian failure and is not able to have a biological child. Based on the outcome of this case, it appears that the pre-pubertal state truly serves as protection against ovarian failure.

Study of resected specimens of ectopic pregnancy: A-5 year experience in Regional Institute of Medical Sciences Hospital, Imphal

Background: Ectopic pregnancy remains the leading cause of maternal death in early pregnancy. It is assuming greater importance because of its increasing incidence and its impact on woman's fertility. Objectives: To study the histomorphological changes of ectopic pregnancy and its correlation with relevant parameters such as age, site, parity, and gestational age. Materials and Methods: This study was conducted in the Department of Pathology, Regional Institute of Medical Sciences, Imphal, for a period of 5 years (January 2015–December 2019). All the specimens with a clinical diagnosis of ectopic pregnancy were included in the study. Histomorphological changes and other relevant parameters such as age, site, parity, and gestational age were analyzed. Results: A total of 160 ectopic pregnancies were diagnosed during the study period. A total number of pregnant women attending antenatal outpatient department during the study period was found to be 121,1941 giving an overall rate of occurrence of 0.13% or 1.31/1000 pregnancies. The most common site of involvement was fallopian tube (95%), mostly on the right side (64.37%). The most common age group was 30–39 years (mean age 30.8 years). Nearly 91.25% of cases were multiparous presenting mostly in their first trimester. Predominant-associated histopathological findings were chronic salpingitis (43.12%), acute salpingitis (20.62%), and salpingitis isthmica nodosa (7.5%). One case was found to be associated with paratubal cyst. Conclusion: Histopathological examination of resected ectopic pregnancy specimens can give an insight into the etiopathogenesis of ectopic pregnancy, thereby helping in early treatment and preventing recurrence.

1652 Laparoendoscopic Single-Site Surgery (LESS) as a Valuable Option During Pregnancy: A Case Series

Study Objective The study objective is to assess the safety and effectiveness of LESS for management of non-obstetric, gynecological disease processes in pregnant patients. Design A case series of 11 pregnant women [23-42 years] who underwent LESS for various gynecological pathology is presented. If permitted, patients were followed until delivery of the fetus. Setting Surgeries were performed in two institutions between 2015 and 2018. Patients or Participants Patients were selected if laparoscopic intervention was indicated. Interventions The cases include four ovarian cystectomy, three salpingo-oophorectomy, one myomectomy, one salpingectomy, one cerclage, and one paratubal cyst. LESS was performed at the umbilicus. For cases involving simple cysts at the umbilicus, cysts were drained and removed from the single site, and laparotomy was performed without extending the incision. Measurements and Main Results Data including surgical/obstetric history, gestational age at surgery, ultrasound results were collected; and operative duration, intraoperative bleeding, postoperative symptoms, fetal monitoring, pathologic findings, conversion and pregnancy outcomes were measured. Three cases were performed in the first trimester and seven in the second trimester with surgeries lasting between 109 to 298 minutes. Estimated blood loss ranged from 5 to 300 mL, and postoperative symptoms of pelvic or abdominal pain were reported. There was one surgery requiring additional ports but no open surgery conversions or complications. Fetal heart rates were between 136 and 175 bpm. Six patients agreed to follow-up and had successful deliveries. Conclusion LESS can be safely performed by experienced surgeons on pregnant patients requiring a variety of gynecological surgery. Most notably, an open surgical technique can be used through the single-site incision in suitable situations. However, further case studies at multiple centers with large sample sizes are needed for further utilization of this technique.

Paramesonephric duct remnant cyst – A rare case report

Paramesonephric duct cyst is a remnant of caudal ends of the fused embryological paramesonephric ducts. They can be mistaken as paratubal, paraovarian or peritoneal inclusion cysts and hydrosalpinx. Paramesonephric duct cysts a re very rare with peak clinical a incidence between a third and fourth decade of life. Reporting a case of para-mesonephric duct remnant cyst in a 33 years old P2L2. She presented with complaints of mass per abdomen since 3 months. Ultrasound examination showed features of ovarian neoplasm and CECT showed abdomino- pelvic cystic lesion (11x13x16cm) of benign etiology. Cystectomy done and sent for histopathology which came as paramesonephric duct remnant cyst. Reporting a case of para-mesonephric duct remnant cyst in a 33 years old P2L2. She presented with complaints of mass per abdomen since 3 months. Ultrasound examination showed features of ovarian neoplasm and CECT showed abdomino- pelvic cystic lesion (11x13x16cm) of benign etiology. Cystectomy done and sent for histopathology which came as paramesonephric duct remnant cyst. Keywords: Pramesonephric ducts, Anomalous female reproductive, Organs.

A Fifteen-Year Analysis of Rare Isolated Fallopian Tube Torsions in Adolescent Children: A Case Series.

Isolated tubal torsions presenting to the emergency department are a very rare cause of pediatric acute abdominal pain. Since making the diagnosis early is of importance in terms of affecting tubal damage and fertility, we aimed to evaluate cases of isolated tubal torsions in light of the literature. This study included 10 patients under 18 years of age who presented to the emergency department with abdominal pain between January 2003 and December 2018. The mean age was 14.5 ± 1.43 years (range: 12–17 years). The demographic characteristics, surgical findings and techniques, and concomitant pathology results of these patients were retrospectively evaluated. The reason for presenting to the emergency department for the 10 patients included in the study was abdominal pain. The mean duration of hospital admission with pain was 4.97 days. The onset of pain was less than 24 h in seven patients (70%) and more than 24 h in three patients (30%). Of the patients, nine (90%) had tenderness in the lower abdominal quadrant, five (5%) had defense, and three (30%) had rebound. Nausea, vomiting and leukocytosis were present in 50% of the cases. Right and left tubal involvement of the cases was equal. Seven (70%) of the isolated tubal torsions were accompanied by paraovarian cysts. Eight patients (80%) underwent open surgery and two (20%) underwent laparoscopic intervention. Detorsion was performed on five (50%) patients and salpingectomy was performed on five (50%) patients. Isolated tubal torsion should be considered in children presenting with acute abdominal pain in early adolescence. Early diagnosis is important for the preservation of fertility.

Hydatid cyst of Morgagni—the case of a misidentified paratubal cyst as an appendiceal mucocele

Mucinous tumors of the appendix and ovary/fallopian tubes can have similar presentations. Most commonly, these tumors are asymptomatic and found incidentally during surgery. When symptomatic, these pathologies can present with lower abdominal pain, a palpable abdominal mass, nausea/vomiting, fevers, or leukocytosis. It is uncommon for these tumors to be confused with one another with the increased use and sensitivity of preoperative imaging modalities. We present the case of a paratubal cyst (PTC) being misidentified as an appendiceal mucocele on preoperative CT scan.

Opportunistic salpingectomy during hysterectomy for benign indications in women at low and high risk for ovarian cancer

Objective Our study aims to evaluate the role of pathology evaluation of fallopian tubesduring hysterectomy for benign indications for the purpose ofearly detection of serous tubal intraepithelial carcinoma (STIC) in women at high and low risk for ovarian cancer. Material and methods This cross-sectional study was conducted at Minia Maternity University Hospital, Egypt, between June 2015 and December 2017. Our study included all women undergoing hysterectomy for benign conditions in the genital tract. Appropriate histories were taken, as well as physical exams, and laboratory and ultrasound evaluations were done prior to scheduling surgery. Abdominal hysterectomies including opportunistic salpingectomies were performed and the whole specimens including the tubal fimbria were sent to the pathology lab for histo-pathological examination. Results A total of 526 patients met inclusion criteria for this study. The mean age of the study participants was 49.75±8.95 years, the mean parity was 3.91±1.62 and the mean BMI was 24.21±2.38 Kg/m2. The most common surgical indications for hysterectomy were postmenopausal bleeding (34.6%), a clinically benign adnexal/pelvic mass (31.7%), and menorrhagia (24.7%). The fallopian tubes were found to have either no pathology or benign conditions in 500 out of the 526 patients. Among these patients, 56% had no pathologic abnormality. The most common benign conditions were paratubal cysts (25%), endometriosis (9%), torsion (2%) and hydrosalpinx (1%). STIC was identified in the fallopian tubes of 8 out of 526 patients. Conclusions Microscopic examination of the entire fimbriae from all patients regardless of the clinical context represents a novel method of early detection of sporadic tubal carcinoma, a putative precursor to advanced-stage pelvic cancer.

Size threshold for follow-up of postmenopausal adnexal cysts: 1cm versus 3cm.

To assess 3cm size threshold for follow-up of simple cysts in postmenopausal women. Radiology information system was retrospectively queried for "US pelvis complete" over 8years in women > 50years, with keywords ovarian cyst, adnexal cyst, ovarian mass, cystic mass, cystic neoplasm, ovarian neoplasm, and ovarian mass. Premenopausal women were excluded. Cysts, were classified as ≤ 1cm, 1-3cm, 3-5cm, and ≥ 7cm. Largest cysts on each ovary was recorded. EMR and imaging archives were reviewed for assessing size, stability duration, and surgical records. Descriptive statistics and confidence interval were performed. 4388 patients met the initial search criteria. 919 cysts in 896 women (age: 50-91years, mean: 61.5years) were identified. We found 162 cysts ≤ 1cm, 352 1-3cm, 296 3-7cm , and 51 ≥ 7cm cysts. 127 patients with 1-3cm cysts had no follow-up. Final analysis of 225 1-3cm cysts included 203 ovarian and 22 paraovarian cysts (average size = 1.95cm (1.1-3.0cm)). 103 ovarian cysts had less than 2years, and 100 cysts had more than 2years follow-up. All except one ovarian cyst were stable for the entire duration of their follow-up (Mean duration of follow-up 5.4years) (0.3%, 95% CI 0.0-0.05). 40 cysts resolved. One simple cyst increased in size (followed over 3.25years) without suspicious imaging features and benign on surgery. 1-3cm cysts represented the most common size range (> 40%) in postmenopausal women, majority of which are stable over follow-up with benign outcome. 3cm size threshold is appropriate for simple cyst follow-up in postmenopausal women.

Study of some abnormalities in the reproductive system of ewes in Basra province

The aimed of study to examined female reproductive system grossly and histopathological to study of lesion causes infertility or sterility in ewes. This study was conducted on the genital tract of 80 ewes in Basra province. The specimen were randomly collected from Basra slaughter house of different areas of Basra city (Qurna, Zubear, Karma Ali, Abu AL khasab, Hayaniya, alder, Shatt al-Arab)within the period from October 2014 to January 2015.The gross examination of collected specimen was confirmed histologically, pathological changes were found in 28 (35%) of the total cases. and 52 (65%) samples normal. Uterine abnormalities comprised (57.14%), whereas ovarian abnormalities comprised (39.29%) and oviduct abnormalities were (3.57%).The commonest pathological conditions of the uterus was endometritis which comprised (42.86%) of pathological conditions, followed by freemartin (14.29%), these percentages from abnormal cases. The commonest abnormalities of the ovary were ovarian cysts (25%), followed by Para ovarian cysts (14.29%) (3.57%). The abnormalities of the oviduct were less common Paraoviduct, these percentages from abnormal cases.

SAT-290 Expanded Phenotype Associated with RNF135 Intragenic Deletion in a Girl with Peripheral Precocious Puberty

Introduction: RNF135 gene is located within the 17q11.2 region and is often deleted in the NF1 contiguous microdeletion syndrome. Six individuals with suspected pathogenic mutations of RNF135 have been described with similar phenotypes including facial dysmorphism (downslanted palpebral fissures, elongated philtrum, broad nasal tip, thin upper lip, broad forehead), macrocephaly, tall stature, overgrowth, and learning disabilities. We present the first reported case of a patient with RNF135 intragenic deletion and precocious puberty. Clinical Case: Patient had ambiguous genitalia at birth, suspicious for CAH. Laboratory evaluation was normal. At age 2, she presented with breast and pubic hair development over the previous year. Leuprolide stimulation test was not consistent with central precocious puberty. Pelvic ultrasound revealed a paraovarian cyst that was drained at age 4 and pubertal development stabilized. At age 6, had progression of puberty with Tanner III breasts. MRI pelvis showed a large cyst of the left ovary and a post pubertal appearing uterus. Patient underwent left oophorectomy for numerous ovarian cysts and concern for progression of precocious puberty. Pathology showed a serous cystadenoma and pubertal ovary. At age 7 years 5 months, she had torsion of the right ovary and underwent laproscopic detorsion. Biopsy showed extensively hemorrhagic tissue with foci of ovarian stroma. Pubertal development was stable until age 7 years 10 months, when she presented with Tanner IV breasts and Tanner II pubic hair. MRI pelvis showed a multicystic right ovary with follicles. Since age 2, patient had tall stature, with height Z score ranging 3.45-4.47. She was diagnosed with focal epilepsy at age 3.5 years and had a PDA that was coiled at age 4. At age 7, chromosomal microarray showed an 88 base pair deletion at chromosome 17q11.2, including part of the RNF135 gene. Patient has dysmorphic facial features, including hypertelorism, upslanted palpebral fissures, bilateral epicanthal folds, flat nasal bridge, malar hypoplasia, high arched palate. Other dysmorphic body features include dolichocephaly and sandal gap between toes 1 and 2. Patient has fine motor, gross motor, and speech delays. Conclusion: Mutations in the RNF135 gene are rare, with phenotypes only described in 6 individuals to date. Our patient exhibits many phenotypic features seen in described patients with pathogenic variants in this gene, including dysmorphic facial features, developmental delay, and tall stature. This is the first reported case of a patient with RNF135 intragenic deletion presenting with peripheral precocious puberty, cystic ovaries, and focal epilepsy. This case describes several new clinical features that are thought to be associated with a rare RNF135-related overgrowth syndrome.

92: Comparison of surgical management of adnexal masses and/or torsion in pediatric and adolescent population between gynecologists and other physician specialties

Compare surgical approach and procedure type between gynecologist and other surgeon types for management of an adnexal mass and/or torsion in female children and adolescents who are less than 20 years old. Female adolescents and children <20 years old who underwent surgery for management of an adnexal mass and/or torsion between January 2013 and August 2018 were identified in the medical record for inclusion in the study. Neonates (age less than 1 year) were excluded. Chart review was performed to ascertain baseline patient characteristics. Operative records, imaging studies and postoperative visit notes were reviewed to obtain the primary outcome variables: procedure approach (minimally invasive or laparotomy) and procedure type (such as oophorectomy, detorsion). Categorical variables were analyzed with Chi-square or Fisher's exact tests where appropriate based on sample size. Continuous variables were analyzed using paired t-tests. Preliminary analysis of 81 patients who met inclusion criteria was performed. The majority of patients were white (80.3%) and presented with pelvic pain as the initial symptom (92.6%). Imaging characteristics showed mostly simple cysts (42.0%) and suspected torsion (24.7%). The pediatric surgery team made the initial treatment recommendation 66.7% of the time. Although all of the patients included in the study eventually underwent surgery, surgical management was recommended as first-line treatment in 74.1% of patients. Only gynecologists and pediatric surgeons performed the surgeries. Preoperative diagnosis was adnexal torsion in 48.3% of patients seen by pediatric surgeons, as opposed to 13% in the gynecologist group. Pediatric surgeons performed adnexal detorsion in 37.9% of patients compared to 8.7% by gynecologists (p-value 0.009). Although gynecologists were more likely to perform salpingectomy than pediatric surgeons (34.8% and 10.3%, respectively, p-value 0.009), they were more likely to indicate paratubal cyst as the preoperative diagnosis (34.8% compared to 8.6%). No differences in surgical approach, estimated blood loss, and operative time were noted. No intra- or postoperative complications occurred in either group. Surgical management of adnexal masses and/or torsion in female patients between 1 and 20 years old was exclusively performed by gynecologists and pediatric surgeons at our institution. Pediatric surgeons were more likely to perform surgery for adnexal torsion, whereas gynecologists were more likely to indicate paratubal cyst as a preoperative diagnosis. Pediatric surgeons were more likely to perform adnexal detorsion and less likely to perform salpingectomy at time of surgery. Otherwise, no differences were noted in surgical approach (minimally invasive and laparotomy), estimated blood loss, and operative time between the two groups.

Paratubal cyst can present as an acute emergency

Introduction: Paraovarian or Paratubal cysts constitute about 10% of diagnosed adnexal masses. Although they are not uncommon; they rarely cause symptoms and are usually incidentally found. The symptoms occur when they grow excessively, or in case of haemorrhage, rupture or torsion.

Long-term postoperative follow-up of a patient with a borderline serous tumor arising from a paratubal cyst: a case report and review of the literature

Background: Borderline paratubal cysts (BPC) are extremely rare, with only nine cases reported in the literature. Case Report: A 40-year-old woman presented with a large adnexal mass on gynecological examination. The abdominopelvic computed tomography scan revealed a 20×16-cm-sized cystic adnexal mass that contained no solid portion. The CA 125 level was elevated. She underwent a left salpingectomy with paratubal cystectomy, and frozen-section analysis revealed that the mass was benign. However, the final pathological diagnosis was borderline serous paratubal cyst. The patient underwent another surgery, i.e., ipsilateral oophorectomy with contralateral ovarian biopsy. She was followed up for ten years postoperatively, and no recurrence was observed. Conclusion: BPCs are extremely rare, and thus, optimal management methods are unknown. However, conservative surgery is performed in most cases. This is the longest reported follow-up after conservative surgery in a case of BPCs. Continued reporting of BPCs is essential for understanding their prognosis and treatment.

Genital Tract Morphopathology of Red Sokoto and West African Dwarf Does in Makurdi

This study was conducted with the aim to record pathological conditions of the female genital tract of Red Sokoto (RS) and West African Dwarf (WAD) does with the objective of comparing the prevalence of genital tract pathology between the two breeds. Of the 211 (RS) and 221 (WAD) genital tract collected and examined, 104 (49.3%) of RS and 97 (43.3%) of WAD showed different types of pathological conditions. Highest occurrence of pathological conditions found in RS was in the uterus (38.4%), followed by those in the ovary (30.8%), cervix (6.6%), salpinx (6.2%) and vagina (1.4%) while in WAD, pathological conditions were highest in the uterus (28.1%), and followed by ovary (26.8%), salpinx (5.0%), cervix (2.2%) and vagina (0.5%). In RS and WAD does, respectively, endometritis (11.9% and 7.1%) was the most common pathology followed by ovaro-bursal adhesion (10.4% and 5.4%), inactive ovaries (4.3% and 4.9%), cystic Graffian follicles (4.2% and 2.2%), paraovarian cyst (3.3% and 3.1%), uterine haemorrhage (3.8% and 2.7%), and ovarian hypoplasia (2.4% and 4.5%). Other pathological conditions found in RS and WAD does include cervical lesions: cervicitis (2.8% and 1.8%), haemorrhage (3.2% and 0.5%); uterine lesions: hydrometra (1.9% and 1.3%), pyometra (2.8% and 1.8%), mucometra (2.8% and 3.6%), metritis (2.4% and 1.3%), post parturient metritis (2.8% and 1.8%), caruncular atrophy (1.4% and 0.5%), endometrial hyperplasia (1.0% and 1.8%), melanosis (1.9% and 1.8%), post parturient emphysematous metritis (1.4% and 2.2%), perimetritis (1.4% and 2.2%), uterine congestion (1.9% and 2.2%), oedema (1.0% and 0.5%) and Cysticercus tenuicolis cyst (0.5% and 0.5%); esophageal lesions: salpingitis (1.9% and 3.1%), hydrosalpinx (1.0% and 0.5%), tubo-bursal cyst (3.3% and 0.9%), ovarian lesions: cystic corpora lutea (2.8% and 1.8%), oophoritis (0.5% and 1.8%), and Cysticercus tenuicolis cyst (1.0% and 0.9%). Hyperaemia (0.5%) and calcification of cervical caudal rugae (0.5%) occurred in RS only. Genital lesions were not statistically different (P > 0.05) between RS and WAD does. In the two breeds, the 13 - 24 months age group had high prevalence of genital lesions. The current study has shown that endometritis and ovaro-bursal adhesions are the common female genital tract pathological conditions in Red Sokoto and West African Dwarf does. The high prevalence of female genital tract abnormalities may suggest that genital diseases are of serious limitation to goat production in Makurdi.

Single-Site Laparoscopic Management of Complicated Paraovarian Cyst.

Single-Site Laparoscopic Management of Complicated Paraovarian Cyst.

A Pediatric Case of Tubal Torsion Due to Paratubal Cyst Initially Suspected to Be Ovarian Torsion

A Pediatric Case of Tubal Torsion Due to Paratubal Cyst Initially Suspected to Be Ovarian Torsion

Para Ovarian Cyst in 16 Years Old Female; Borderline Ovarian Tumor: A Case Report

Paraovarian cysts are common, accounting for 10–20% of all adnexal lesions, and most of them are benign. On the other side, paraovarian tumors of borderline malignancy are very rare, only about forty cases were reported all over the world. Here, we present a case of 16 years female with left lower abdominal pain, pelvic sonography showed a cystic mass in Douglas pouch with solid mural nodule. She underwent laparoscopy, we detected and extirpated a paraovarian cyst of about 10x10 cm with solid component 3x3 cm and corpus luteum cyst 5x5 cm. After histopathological analysis, it was proved to be borderline ovarian serous tumor Stage Ic according to the International Federation of Gynecology and Obstetrics (FIGO) staging. As till now, there is no clear guideline regarding the management of this tumor; the treatment strategy was determined on the basis of ovarian tumor guidelines, with preservation of fertility. In conclusion, paraovarian cysts is a common disease and usually benign. It rarely causes clinical problems, but caution is necessary as there is a possibility of a malignant or borderline tumor. As in ovarian tumors, even if the size of the solid component of the tumor detected by diagnostic imaging is very tiny, malignant or borderline malignant tumors should be considered.