1
|
Singh S, Agarwal I, Begum J, Bhardwaj B. The burden of paraovarian cysts - a case series and review of the literature. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2023; 22:105-110. [PMID: 37674926 PMCID: PMC10477768 DOI: 10.5114/pm.2023.128054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 12/09/2022] [Indexed: 09/08/2023]
Abstract
Introduction A paraovarian cyst (POC) is a cyst in the broad ligament or mesosalpinx. Paraovarian cysts have an estimated prevalence of 5-20% amongst the adnexal masses. Despite the high prevalence and availability of advanced imaging modalities, an accurate pre-operative diagnosis of POC is still made in less than 50% of patients. Case reports Two females with suspected ovarian torsion underwent laparotomy and had POCs. A 42-year-old hysterectomized female underwent surgery for a suspected POC which turned out to be a mesenteric cyst. Two females underwent laparotomy for suspected mesenteric cysts which turned out to be POCs. A nulliparous female with infertility conceived spontaneously after cystectomy of POC. Results Optimal management of an adnexal mass depends on the knowledge of the origin and the exact nature of the mass. No clear-cut guidelines exist for the management of POCs despite their high prevalence. There is a need for further research on this topic to formulate clear-cut guidelines for their management. Conclusions Radiologists and gynaecologists need to keep them in mind as differentials for patients with adnexal masses to ensure a correct pre-operative diagnosis in order to achieve an optimal outcome for these females. Gynaecologists need to be aware of the cases which can be managed conservatively and those that need surgery, along with the extent of the surgery required, taking care to protect the ovary at all costs, particularly in benign cases.
Collapse
Affiliation(s)
- Sweta Singh
- All India Institute of Medical Sciences, Bhubaneswar, India
| | - Ishita Agarwal
- All India Institute of Medical Sciences, Bhubaneswar, India
| | - Jasmina Begum
- All India Institute of Medical Sciences, Bhubaneswar, India
| | | |
Collapse
|
2
|
Stefanopol IA, Baroiu L, Neagu AI, Danila DM, Nechifor A, Miulescu M, Balan G, Vasile CI, Niculet E, Tatu AL. Clinical, Imaging, Histological and Surgical Aspects Regarding Giant Paraovarian Cysts: A Systematic Review. Ther Clin Risk Manag 2022; 18:513-522. [PMID: 35516165 PMCID: PMC9064068 DOI: 10.2147/tcrm.s361476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/10/2022] [Indexed: 11/23/2022] Open
Abstract
Paraovarian cysts (POCs) develop within the broad ligament of the uterus. POCs are considered to be giant when the threshold of 150 mm is exceeded. Clinical signs and symptoms occur as a consequence of the pressure effect on adjacent organs or due to complications. Abdominal ultrasonography, computed tomography or magnetic resonance imaging are useful imaging tools, but most often the exact origin of such voluminous cysts is revealed only by surgical exploration. The review aims to appraise and update the diagnostic, the histological aspects and the treatment of the giant POCs in rare cases. We carried out a systematic search in Medline-PubMed, Google Scholar and ResearchGate electronic databases. Twenty-seven papers fulfilling the selection criteria were included in the review. The data extracted included information about first author, year of publication, country, patient age, size and side of the POCs, symptoms, tumoral markers, imaging methods, preoperative diagnosis, surgical management and histopathological findings. Although not very numerous, all the studies highlighted the low incidence of giant POCs, the impossibility of establishing the origin of the cystic mass by clinical and imaging methods even with advanced technical tools and the low risk of torsion (11.1%). Despite the recognized benign nature of POCs, we found an unexpected high percent (25.9%) of borderline giant POCs. Surgical excision is the only treatment option. Ovarian-sparing surgery was performed in 85.1% of the cases, and minimally invasive techniques were applied in only 42.9% of the patients, which demonstrates the need of a high-level laparoscopic expertise. Knowledge of this pathology, its recognition as a possible etiology of an abdominopelvic cyst, and a higher awareness of the possibility of a borderline histology in giant POCs are required for the proper management of these particular cases.
Collapse
Affiliation(s)
- Ioana Anca Stefanopol
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania.,Department of Pediatric Surgery and Orthopedics, "Sf Ioan" Clinical Emergency Hospital for Children, Galați, Romania
| | - Liliana Baroiu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania.,Infectious Diseases Department, "Sf Cuv Parascheva" Clinical Hospital of Infectious Diseases, Galați, Romania
| | - Anca-Iulia Neagu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania.,Department of Anatomopathology, "Sf Ioan" Clinical Emergency Hospital for Children, Galați, Romania
| | - Dumitru Marius Danila
- Department of Pediatric Surgery and Orthopedics, "Sf Ioan" Clinical Emergency Hospital for Children, Galați, Romania.,Clinical Surgical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
| | - Alexandru Nechifor
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
| | - Magdalena Miulescu
- Research Center in the Functional Cardiorespiratory and Neuromotor Exploration, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania
| | - Gabriela Balan
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania.,Department of Gastroenterology, "Sf Ap Andrei" Emergency County Clinical Hospital, Galați, Romania
| | - Claudiu Ionut Vasile
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania.,"Elena Doamna" Clinical Hospital of Psychiatry, Galaţi, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania.,Department of Pathology, "Sf Ap Andrei" Emergency County Clinical Hospital, Galați, Romania
| | - Alin Laurenţiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, Romania.,Research Center in the Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, Galați, Romania.,Dermatology Department, "Sf Cuv Parascheva" Clinical Hospital of Infectious Diseases, Galați, Romania.,Multidisciplinary Integrated Center of Dermatological Interface Research MIC DIR, Dunarea de Jos" University, Galati, Romania
| |
Collapse
|