- Nesa Asnafi
 - - Department of Obstet . and Gynecol , Yahyanejad Hospital, Babol Medical Sciences University, Babol, Iran
- Shahryar Shafai
- - Department of Pathology, Yahya Nejad Hospital, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
- Majid Sharbatdaran
- - Department of Pathology, Yahya Nejad Hospital, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
Received: 4/1/2004 Accepted: 4/1/2004 - Publisher : Avicenna Research Institute |
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Abstract
Introduction: Paraovarian cysts originate from peritoneum, tube or Wolfian ducts. They are usually very small and their maximum diameter is two centimeters, most often discovered accide-ntttally during the operation. In sonographic view, they have the same characteristics as ovarian cysts, being differentiated by smaller size, adjacency to ovary and persistence. Rupture, hemorrh-age and torsion of paraovarian cysts occasionally occur, but their voluminous enlargement rarely happens. The aim of the present case report is introduction of the probability, diagnosis and treat-ment of huge paraovarian cysts. Case Report: The patient was a 48 years old woman with history of four cesarean deliveries and no abortions (G4P4Ab0), referred to Gynecology Clinic of Shahid Yahya Nejad Hospital, Babol, complaining about abdominal distension and vaginal bleeding. In physical examination, a distend-ed abdomen with a soft tumor extended form pelvis to over umbilicus was palpable. Laparotomy was planned using sonographic diagnosis of pelvic mass. The uterine size was found to be larger than normal (1109481mm) during the operation. The right ovary was normal but the left ovary contained a small 3cm cyst. A huge cystic mass, originating form lateral side of the right ovary, filled the whole abdominal cavity up to the diaphragm. A sample of 20ml of the cystic fluid was first aspirated with syringe and sent for cytological study. Then 2800 ml fluid from the cyst was evacuated. Finally, cystectomy and total hysterectomy with bilateral salpingo-oophorectomy was performed. The pathology report was paraovarian cyst. Conclusion: According to many reports, when a sonographic study shows the ovaries close to a pelvic cyst, paraovarian cyst is one of the first diagnostic choices and accordingly the treatment plan could be selected with a cyst aspiration followed by laparoscopic cystectomy or laparotomy.
Keywords:
Paraovarian cyst, Pelvic cyst, Abdominal distention, Ovarian cyst To cite this article:References
- Howard W.J., Anne C.W., Lourie S.B. Novak’s Text book of Gynecology. 11th Edition, Williams & Wilkins.1988;pp:778.
- Cotran R.S., kurmar V., Collins J. Robbin’s pathologic basics of diseases. 6th Edition, W.B. Saunder Company.1999;pp:1036-1060.
- Callen P.W. Ulterasonography in obstetrics and Gynecology.4th Edition, W.B. Sounders company. 2000;pp:868.
- Rayan K.J., Berkowitz R.S., Barbieri R.L., Dunaif A. Kistner’s Gynecology & womens Heal- th. 7th Edition, Mosby.1999;pp:150.
- Scott J.R., Disaia P.J., Hammoned C.B., Spell-acy W.N. Danforth’s Obestetrics & Gynecology. 8th Edition. Lippincott Williams & Wilkins.1999; pp:865.
- Macarthur M., Mahomed A.A. Laparoscopy in the diagnosis and management of a complicated paraovarian cyst. Surg Endosc.2003;15;17(9).
- Korbin C.D., Brown D.L., Welch W.R. Para ovarian cystadenomas and cystadenomas and cys-Tadenofibromas: sonographic characteristics in 14cases. Radiology.1998;208:459.
- Berek J.S. Novak’s text book of Gynecology. 13th Edition Lippincott Williams & Wilkins.2002; pp:389.
- Varras M., Akrivis Ch., Polyzos D., Frakala S., Samara Ch. A voluminous twisted paraovarian cyst in a 74-year– old patient: case report and review of the literature. Clin Exp Obstet Gynecol. 2003;30(4):253-6.
- Kim J.S., Woo S.K., Suhs J. et al.Sonographic diagnosis of para ovarian cyst. value of detecting a separate ipsilateral ovary.AJR.1995;164:1447.
- Cevrioglu A.S., Polat C., Fenkci V., Yilmazer M., Yilmaz S., Dilek O.N. Laparoscopic manage-ment following ulterasonographic– guided drain-age in a patient with giant paraovarian cyst. Surg Endosc.2004;18(2):346.
- Kishimoto K., Ito K., Awaya H., Matsunage N., Outwater E.K., Siegelman E.S. Paraovarian cyst: MR imaging features. Abdom Imaging.2002;27(6):685-9.
- Okada T., Yoshida H., Matsunage T., Kouchi K., Ohtsuka Y., Takano H., Horie H., Ohnuma N. Paraovarian cyst with torsion in children. J pediatr Surg.2002;37(6):937-40.
- Lurie S., Golan A., Glezerman M. Adnexal torsion with a paraovarian cyst in a teenage girl. J Am Assoc Gynecol Laparosc.2001;8(4):597-9.
- Vlahakis– Miliaras E., Miliaras D., Koutsomis G., Miliaras S., Spyridakis I. Papadopoulos M.S. Paratubal cyst in young females as an incidentalfinding in laparotomies performed for rigth lower quadrant abdominal pain. Pediatr Surg Int.1998; 13(2-3):141-2.
- Darwish A.M., Amin A.F., Mohammad S.A. Laparoscopic management of paratubal and para- ovarian cysts. JSLS.2003;7(2):101-6.
- Barloon T.J., Brown B.P., Abu– yousef M.M., Warnock N.G. Paraovarian and paratubal cyst: preoperative diagnosis using transabdomial and transvaginal sonography. J Clin Ultrasound.1996; 24(3):117-22.
- Narurkar S.D., Buch A.C. Patel K.D., Avasare S.S., Niyogi G.M. Papillary cystadenocarcinoma arising in a Paratubal mesothelial Cyst of the mesosalipinx – (a case report). Indian J Cancer. 2001;38(2-4):137–42.