Perineural (Tarlov) cysts mimicking adnexal masses: a report of three cases

H’ng, Martin Weng Chin; Wanigasiri, U.; Ong, Caroline

doi:10.1002/uog.6448

Cited by 21 publications

(27 citation statements)

References 9 publications

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“…Detailed ultrasound scanning may provide a clue to the correct diagnosis. Sonographic features reported of perineural cysts include (1) multiseptated complex cysts with internal debris, which may be separate from the ovaries; (2) posterior location in the pelvis, adjacent to the sacrum; (3) lack of mobility due to their extraperitoneal location [7][8][9]. If the clinical diagnosis is in doubt, magnetic resonance imaging should be used to confirm the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Dysmenorrhoea and Adnexal Cysts - A Rare Presentation of Tarlov Cysts in the Pelvis

Lee¹

2015

J Clin Case Rep

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A 41 year old, married for 20 years, presented on 28 th May, 2013 with history of dysmenorrhoea, deep dyspareunia, and pelvic pain for the past 6 months. She was nulliparous and practiced contraception by using condoms. Her menstrual pattern was essentially normal and the pain occurred mainly on the first two days of her period. Initial vaginal ultrasound scanning revealed multiple adnexal cysts on both sides of the pelvis (Figure 1a) with the largest one measured at 5 cm on the left. Bimanual pelvic examination elicited tenderness over the uterosacral ligaments and demonstrated the presence of the cystic adnexal masses. The initial diagnosis was probable ovarian endometrioma and pelvic endometriosis. Laparoscopy was performed with a view to excise any endometriotic lesions and to perform ovarian cystectomy on 1 st June, 2013. Except for a small left ovarian dermoid that was removed at the operation, the uterus, and tubes, right ovary and uteroscral ligaments AbstractTarlov cysts are meningeal dilations of the posterior spinal nerve root. The cysts can grow as a result of an increased inflow of cerebrospinal fluid giving rise to symptoms due to compression or stretching of the adjacent nerve roots. They are usually multiple and asymptomatic, but Tarlov cysts in the sacral neural canal and foramina can be associated with symptoms like radicular pain, low back pain, paresthesia, and urinary or bowel dysfunction. To the best of our knowledge, Tarlov cysts presented with dysmenorrhea has not been reported in the literature. This association, though rare, should not be overlooked, especially when there is enough clinical suspicion while investigating an atypically looking adnexal cyst while managing in the context of dysmenorrhea or pelvic pain. MRI is recommended when the exact diagnosis is in doubt. Laparoscopic excision of the cyst is feasible and in our case it has been shown to be effective and safe. were grossly normal but there was no evidence of any endometriosis. On the contrary, bilateral retroperitoneal cystic swellings were seen lying underneath the uterosacral ligaments and rested against the pelvic floor on both sides (Figure 1b). The cyst on the left side was more prominent and dissection was carried out to completely isolate the cyst after the ureter was lateralized and the rectum deflected to the opposite side using the rectal probe. The cyst was thin walled, smooth, containing clear fluid, and fibrous in nature (Figure 1c). A pedicle was found connecting the cyst to a cystic tubular neurogenic-like structure that lied across the pelvic floor (Figure 1d). The cyst was excised after its rupture with the release of a lightly yellowish clear fluid. The inner wall of the cyst was smooth with no communicating channels identifiable. No further procedure was performed in view of the uncertainty of the pathology involved. The immediate postoperative recovery was uneventful and the patient was discharged home on the first postoperative day. She returned in a week for assessment and reported shooting pain over...

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Section: Discussionmentioning

confidence: 99%

Dysmenorrhoea and Adnexal Cysts - A Rare Presentation of Tarlov Cysts in the Pelvis

Lee¹

2015

J Clin Case Rep

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“…The concept of this disease was established in 1938 when Tarlov reported 5 cases of a lumbosacral perineural cyst during a postmortem examination [3,4]. …”

Section: Discussionmentioning

confidence: 99%

“…A myelography or a CT after the myelography can reveal a cyst on the delayed image. MRI can reveal a cyst that exhibits the same signal intensity as that of the cerebrospinal fluid [4,8-11]. …”

Section: Discussionmentioning

confidence: 99%

A symptomatic lumbosacral perineural cyst -A case report-

Choi

Kim

2012

Korean J Anesthesiol

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Lumbosacral perineural cysts are formed by the arachnoid membrane of the nerve root at the lumbosacral level. Most of these cysts are asymptomatic and are found incidentally during computed tomography (CT) or magnetic resonance imaging (MRI) for other causes of chronic lower back pain. This type of cyst requires a differential diagnosis to distinguish it from other causes of radiating pain and neurological symptoms. In the present case, a symptomatic lumbosacral perineural cyst was found, and pain relief was achieved by non-surgical treatment. A lumbosacral perineural cyst was identified from a differential diagnosis of a lumbar disc disorder that presented as radiating pain and neurological symptoms.

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“…Similarly, perianal pain may be one of the presentations of PCs [5]. They may also present as adnexal masses that upon further evaluation are revealed as PCs [6]. Infertility and retrograde ejaculations may also occur secondary to the compressive symptoms of PCs [7].…”

Section: Letter To Editormentioning

confidence: 99%

Rare Clinical Presentations of Perineural Cysts Besides Radicular Pain

Kapoor

2012

Korean J Pain

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Perineural (Tarlov) cysts mimicking adnexal masses: a report of three cases

Cited by 21 publications

References 9 publications

Dysmenorrhoea and Adnexal Cysts - A Rare Presentation of Tarlov Cysts in the Pelvis

Dysmenorrhoea and Adnexal Cysts - A Rare Presentation of Tarlov Cysts in the Pelvis

A symptomatic lumbosacral perineural cyst -A case report-

Rare Clinical Presentations of Perineural Cysts Besides Radicular Pain

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