An incidental diagnosis of a giant paraovarian cyst in a female teenager

Abstract

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.

Pediatric ovarian tumors, a challenge for pediatrician and gynecologist

“…[5] Due to the rarity of malignant conditions in pediatric ages, laparoscopy became the first choice even for cystic lesions of up to 25 de cm considered benign, [5] being a viable option even in giant paraovarian cysts. [28] In case of malignant tumors stage IA–IC, when the cyst content is spilled into the peritoneal cavity, adjuvant treatment may be required or even laparotomy. [7] Nevertheless, Seckin et al [29] found strong correlation between the operative diagnosis and the histopathological exam underlining that under the circumstances of a thorough exploration of both tumor and pelvis, laparoscopic approach may be a safe procedure in adolescents.…”

Giant paraovarian cyst in an adolescent: a challenge of accurate diagnostic

“…Paraovarian cysts (POCs), usually located along the fallopian tube, arise from the mesosalpinx or the broad ligament. They are cystic structures lled with serous uid [2], and regarding their embryological origin, 68% are mesothelial, 30% are embryonic vestiges of paramesonephric (Müllerian) ducts and 2% of mesonephric ducts [1,6]. Müllerian-derived structures are lined by a secretory epithelium, responsible for the cystic dilation; they are also hormonal in uenced, which explains the incidence in postpubertal patients and why they can reach huge sizes [6].…”

“…Paraovarian cysts originate in embryologic remnants located in the broad ligament, between the fallopian tube and the ovary. The vestiges may be mesothelial, paramesonephric or mesonephric [1]. POCs represent about 10 % of all adnexal masses, being more common in the third or fourth decade of life [1,2].…”

“…The vestiges may be mesothelial, paramesonephric or mesonephric [1]. POCs represent about 10 % of all adnexal masses, being more common in the third or fourth decade of life [1,2].…”

“…POCs are ordinarily asymptomatic [3]. Their average size is 1 to 8 cm [4], but they grow slowly and constantly, becoming symptomatic due either to the giant sizes, or to a complication such as torsion [1,5].…”