Thirty-eight cases of paraovarian cysts in children and adolescents: a retrospective study.

PURPOSE: Paraovarian cysts in children and adolescents can be challenging to accurately diagnose prior to surgery. Our objective is to outline the clinical characteristics of paraovarian cysts and enhance the precision of diagnosing paraovarian cysts in this age group. METHODS: We retrospectively analyzed all patients with paraovarian cysts who underwent surgery in our department from 2013 to 2021. The review focused on demographic characteristics, clinical manifestations, intraoperative findings, and postoperative pathology of these patients. RESULTS: This cohort was composed of 38 children with paraovarian cysts. The average diameter of the cysts was 4.8 cm (range 0.5-10 cm). Among the cases, 25 (65.8%) had adnexal torsion. Postoperative pathology showed that all cases were simple cysts with serous fluid. After the procedure, the patients were monitored for a period ranging from 12 to 108 months. B-ultrasound and physical examination did not reveal any significant abnormalities. CONCLUSIONS: B-ultrasound can help diagnose paraovarian cysts by detecting slight deviation movement between the cyst and the uterus. The presence of adnexa torsion in children and adolescents with paraovarian cysts does not depend on BMI, but rather on the size of cysts. Laparoscopic cyst removal has proven to be an effective surgical approach with favorable outcomes.

Giant paratubal cyst: report of a case in second level public hospital.

BACKGROUND: Giant paratubal cysts are mostly benign tumors, with an incidence of 10%. The incidence rate of neoplasms is 2% to 3%, including papillary carcinoma and serous papillary neoplasms. CASE REPORT: A 35-year-old woman who began her current condition 3 years after her pregnancy, with urgency when urinating, abdominal pain and sensation of abdominal mass, who was diagnosed and protocolized in a second public level hospital of the State of Mexico, treated with open surgery, and good postoperative evolution.

ANTECEDENTES: Los quistes paratubáricos gigantes son en su mayoría tumores benignos, con una incidencia del 10%. La tasa de incidencia de neoplasias es del 2 al 3%, incluyendo carcinoma papilar y neoplasias papilares serosas. CASO CLÍNICO: Mujer de 35 años que comenzó su condición actual 3 años después de un embarazo, con urgencia al orinar, dolor abdominal y sensación de masa abdominal, que fue diagnosticada y protocolizada en un hospital público de segundo nivel del Estado de México, tratada con cirugía abierta y con buena evolución posoperatoria.

Leiomyoma with Bizarre Nuclei (Symplastic Leiomyoma) in the Paratubal Cyst Wall: Report of a Rare Case.

Leiomyoma is a benign mesenchymal tumor that develops from smooth muscle cells. It can present in various histological variants. Leiomyoma with bizarre nuclei is an infrequent variant of uterine smooth muscle neoplasm. It is characterized by focally or diffusely distributed bizarre cells on the background of a typical leiomyoma. These bizarre cells are large, multinucleated, or multilobulated and have an eosinophilic cytoplasm. Even though leiomyomas with bizarre nuclei display benign clinical behavior, their differential diagnosis from leiomyosarcoma can sometimes be difficult. Leiomyoma has been described most commonly in the uterus. There is no case of leiomyoma originating from paratubal cysts described in the literature. In this article, we present a rare case of leiomyoma with bizarre nuclei originating from a paratubal cyst.

Paratubal Cyst Recurrence in Children and Adolescents.

STUDY OBJECTIVE: To examine the association between patient characteristics and risk for recurrence risk of paratubal cysts (PTC) in children and adolescents. DESIGN: Retrospective chart review at a single institution. SETTING: Single academic children's hospital. PARTICIPANTS: Pediatric patients presenting to Texas Children's Hospital between July 2007 and March 2019. Patients were identified for the study by reviewing pathology reports and were included if they met inclusion criteria of a pathologic diagnosis of a paratubal or paraovarian cyst removed during any surgical procedure between July 2007 and March 2019. INTERVENTIONS: Subjects with pathologic diagnoses of a paratubal cyst during the study period underwent chart review for the following data points: age at presentation, ethnicity, pathologic recurrence of paratubal cysts, pubertal status, body mass index (BMI), diagnosis of polycystic ovary syndrome (PCOS), size of cyst, laterality of cysts, and number of cysts. MAIN OUTCOME MEASURE(S): Recurrence, Pathology types. RESULTS: Of the 627 patients that met inclusion criteria, the incidence of recurrence was 11.3%. Group 1 included those with recurrence of PTC (N = 70). Group 2 was identified as those without recurrence of PTC (N = 557). There were no differences related to age, BMI, ethnicity, history of PCOS, cyst size, laterality or number of cysts present. PTC NOS and serous PTC occurred most frequently. Of the unique cases involving recurrence, 70.1% recurred on the ipsilateral side. There were no cases of paratubal cyst malignancies in this cohort. The range of pathology diagnoses included pathologies that may occur in ovarian cysts. This is particularly interesting, given the known origins of ovarian cancer from fallopian tube transformations. Rare pathology diagnoses likely did not occur with frequency to determine definitive risks of recurrence in these cases. CONCLUSIONS: There appears to be a baseline recurrence risk for PTC, for which patients can be counseled. Recurrence does not appear to be associated with any particular pathology type, cyst size, number of cysts, BMI, PCOS, or puberty stage. Recurrence, should it occur, appears to occur more commonly on the ipsilateral side.

Giant Paratubal Serous Cystadenoma in an Adolescent Female: Case Report and Literature Review.

BACKGROUND: Paraovarian/paratubal cysts constitute 5-20% of all adnexal lesions and typically originate from the paramesonephric or Müllerian duct. The primary epithelial tumors arising from paraovarian cysts account for 25% of the cases, but giant cystadenomas of paraovarian origin are extremely uncommon during childhood and adolescence with very few cases reported in the literature. CASE: We present the case of a 15-year-old female that presented with a bulky mass in the abdomen and pelvis. An initial clinical and radiological examination indicated an ovarian cyst measuring ∼25 × 20 cm. However, explorative laparotomy revealed a giant paratubal cyst that was successfully treated with complete excision using fertility-sparing surgery. Histopathological examination was consistent with a serous cystadenoma. The postoperative course was uneventful and the girl was discharged on the seventh postoperative day. At the follow-up of 6 months, the patient was doing well.

Paratubal borderline serous tumor in a postmenopausal woman: a case report.

Unlike borderline ovarian tumors, paratubal borderline tumors are extremely rare gynecologic tumors. They occur in reproductive-aged females at an earlier stage of disease and have a good prognosis. A 61-year-old woman, gravida 3 para 3, presented with progression of ovarian cyst. Computed tomography revealed a 6-cm simple cystic lesion without enhancing papillary projections. The patient underwent total laparoscopic hysterectomy and bilateral salpingo-oophorectomy. Frozen specimens showed that the tumor was benign, thereby confirming a final diagnosis of paratubal borderline serous tumor. The patient refused comprehensive surgical staging and opted for close follow-up. The patient remains asymptomatic with no evidence of recurrence at the 24-month follow-up. To the best of our knowledge, this is the first reported case of paratubal borderline serous tumor in a postmenopausal patient. The findings of this study and those of other case reports can contribute to the understanding, diagnosis, treatment and prognosis of these rare tumors.

An incidental diagnosis of a giant paraovarian cyst in a female teenager: A case report.

RATIONALE: Paraovarian cysts (PCs) are cystic tumors that can be encountered between the ovarian hilum and the ovarian fimbria located within the mesosalpinx and broad ligament, being usually diagnosed within the 3rd and 4th decade of life. PATIENT CONCERNS: We report the case of a 15-year-old female admitted in our clinic for consciousness loss, who was incidentally diagnosed with a giant pelvic cystic at ultrasound. DIAGNOSES: The magnetic resonance image showed a cystic mass of 170/140/85 mm, suggesting an origin from the left ovary, reaching the subhepatic area. INTERVENTIONS AND OUTCOMES: The surgical intervention revealed 3 PCs, a giant one and 2 smaller ones within the large ligament. The cysts were removed by laparoscopic approach, and the histologic examination did not reveal any signs of neoplasia. LESSONS: In addition to their rarity, giant PCs can be an incidental diagnosis in patients presenting unrelated symptoms resulting in increased difficulties related to the diagnosis. Moreover, the imagistic tools might not establish precisely the origin of these cysts, and therefore, the final diagnosis and treatment approach could be determined sometimes only during the surgical intervention.

Endometrioid Adenocarcinoma Arising in a Paratubal Cyst: A Case Report and Review of the Literature.

A 56-year-old G3P3 postmenopausal woman presented with a 5 month history of abnormal uterine bleeding and pelvic pain. A computed tomographic scan revealed a 5 cm right adnexal cystic mass in addition to a thickened, heterogenous endometrium and leiomyomatous uterus. A total laparascopic hysterectomy and bilateral salpingo-oophorectomy with omental and peritoneal biopsy were performed. Gross examination revealed a 12 week size uterus with small fibroids, normal bilateral atrophic ovaries, and a right paratubal cyst. A 4 cm vegetating mass was found in the right side of the uterine wall. Microscopically, the uterine mass was diagnosed as an endometrioid adenocarcinoma (EAC) FIGO 1 with 70% of myometrial invasion. The remaining endometrium showed a complex atypical hyperplasia. In addition, a 5 cm paratubal cystic mass was found that was separate from the uterus and the right adnexa. The cyst content was a chocolate brown fluid and the cyst wall was smooth with a single solid mass of 2 cm in size. The diagnosis of EAC, FIGO 1 was given. The remaining cyst lining showed endometriotic cyst and foci of endometriosis in the cyst wall. There was no lymphovascular invasion. The entire fallopian tube and ovaries were submitted and they were free of tumor. The patient was diagnosed with primary EAC of the paratubal cyst in addition to EAC of the uterine corpus (pT1b). A close follow-up was recommended. Because of our limited knowledge of carcinomas arising in the paratubal cyst, we will review the literature and discuss their clinical aspects, management, and behavior.

Adenocarcinoma mucinoso del paraovario: un tumor infrecuente / Mucinous paraovarian adenocarcinoma: a rare tumour

Se denomina tumor del paraovario a aquel que se desarrolla en los tejidos cercanos al ovario. Dado que generalmente no producen manifestaciones clínicas, su diagnóstico se suele realizar de forma incidental durante cirugías, estudios de fertilidad o post-mortem. Aunque la degeneración neoplásica de estas lesiones es altamente infrecuente, cuando ocurre puede dar lugar a tumores tanto de bajo como de alto grado. Presentamos un caso de adenocarcinoma mucinoso del paraovario intervenido en nuestro centro y revisamos la literatura disponible del tema (AU)

Paraovarian tumors are those that arise from tissues surrounding the ovaries. Given that they do not normally cause symptoms, they are usually diagnosed during surgery, fertility studies, or post-mortem. Neoplastic transformation of these lesions is highly infrequent but can give rise to low-grade (borderline) as well as high-grade tumours. We present a case of paraovarian mucinous adenocarcinoma and provide a review of the available literature on the subject (AU)

[Differential diagnosis of abdominal cysts in children]. / Hasi cysták és cystosus képletek differenciáldiagnózisa gyermekkorban.

19 children were diagnosed with abdominal cysts of different origin in the Surgical Unit of the Department of Pediatrics, Medical University of Pécs, Hungary between 2010 and 2013. The authors discuss the details of representative cases of a parovarial cyst, an intestinal duplication, and an omental cyst with emphasis on the clinical symptoms, diagnostic tools, and surgical interventions. The authors conclude that abdominal cysts often cause mild symptoms only, and they are discovered accidentally by ultrasound imaging performed for other reasons. In some cases, the cyst can cause severe complaints or even acute abdomen requiring emergency surgery. Laporoscopy may be a valuable method both in diagnosis and surgical therapy. Abdominal CT or MRI are not required in the majority of the patients.