Diagnostic and Management of Undescended Ovary – A Preoperative Dilemma: A Case-Based Systematic Review

Abstract

Undescended ovary (UO) is an uncommon congenital condition characterized by the presence of the adnexa above the common iliac vessels, with an estimated incidence of 0.3-2%. Because of its rarity, it is usually presented as a case report. A thorough knowledge of the ovarian embryological development is essential for the clinician, who must be warned about the possibility of associated Müllerian and renal malformations. There may be asymptomatic patients, incidentally diagnosed during infertility evaluation, but when symptoms occur, these are unspecific and most often this disorder is misdiagnosed, the accurate diagnosis being established intraoperatory. The malignant potential of an UO is accepted, although no such cases were reported. The role of the UO in infertility is still unclear, despite evidence of its normal function. Complications are linked to the ovary (cyst formation, cyst ruptures or tumors) or to the undescended fallopian tube (ectopic pregnancies). The management should be conservative, but there is no consensus about whether it is necessary to excise the ipsilateral undescended tube. We included a short case presentation of an UO cystadenoma misdiagnosed as a renal cyst, which depicts all diagnostic and management dilemmas and inspired us to write this review. The present literature review includes all the cases reported from the early 20th century to the present, with updated data about epidemiology, pathophysiology, clinical and imaging diagnosis, treatment options and prognosis of this rare condition. This paper aims to establish some directions in the diagnosis and management of similar patients and to remind us that, no matter how advanced the imaging investigation techniques might be, a correct preoperative diagnosis may often be missed.

Clinical, Imaging, Histological and Surgical Aspects Regarding Giant Paraovarian Cysts: A Systematic Review

“…In females, both the uterus and the fallopian tubes develop from the paramesonephric (Müllerian) ducts. 36 The mesonephric (Wolffian) ducts usually regress, but they may persist as embryonic remnants (epoophoron, paroophoron, Gartner’s ducts). 37 , 38 Depending on their embryological origin, POCs have different location, histological features and evolution.…”

Ovarian absence: a systematic literature review and case series report

“…1) Rule out ovarian ectopy. An ectopic ovary may be detected along the line of descent – the presence of bilaterally intact fallopian tubes may increase the suspicion for maldescent [ 81 ]. If a heterotopic location is confirmed, standard of care surveillance of the gonad is warranted [ 82 ].…”

Fetal Growth Restriction and Clinical Parameters of Newborns from HIV-Infected Romanian Women

“…The staff at our clinic continues to improve the healthcare provided to HIV-infected patients, especially the women of childbearing age, to allow them the chance to have a healthy child [ 13 , 14 , 15 , 16 , 17 , 18 ]. Our study shows that there were no differences in the sex of the newborns between the Constanta and Craiova RCs, with more than 50% being boys.…”