From the Guidelines
Paraovarian cysts and ovarian cysts differ primarily in their location and origin, with paraovarian cysts developing in the mesosalpinx between the fallopian tube and ovary, and ovarian cysts forming directly within or on the surface of the ovary. The key distinction between these two types of cysts lies in their embryological origin and anatomical location. Paraovarian cysts, also known as parovarian cysts, originate from remnants of embryonic structures like the mesonephric or paramesonephric ducts, and are typically found in the mesosalpinx, a region between the fallopian tube and the ovary 1. In contrast, ovarian cysts arise from the ovary itself and can be either functional, such as follicular or corpus luteum cysts, or pathological, including dermoid cysts or cystadenomas.
Some of the main characteristics of paraovarian cysts include:
- They are usually asymptomatic and fluid-filled
- Not connected to the ovary itself
- Originate from embryonic remnants in the mesosalpinx
- Typically benign in nature
On the other hand, ovarian cysts:
- Can be functional or pathological
- Form directly within or on the surface of the ovary
- May cause symptoms such as pelvic pain, bloating, or menstrual irregularities
- Have a higher potential for complications, including torsion, rupture, or malignancy
Diagnosis of both types of cysts often involves pelvic examination, ultrasound, and sometimes other imaging techniques to distinguish between them. According to recent guidelines, simple cysts, including paraovarian and paratubal cysts less than 5 cm in premenopausal women, do not require follow-up 1. For larger cysts or those with suspicious characteristics, further evaluation and potential surgical intervention may be necessary. Regular gynecological check-ups are essential for monitoring any pelvic cysts, regardless of their origin, to ensure timely detection and management of potential complications. A recent study demonstrated that the risk of malignancy in benign-appearing lesions on ultrasound is less than 1% 1, supporting a conservative approach to management in many cases.
From the Research
Difference between Paraovarian and Ovarian Cysts
- Paraovarian cysts arise from the mesothelium or paramesonephric remnants, and are typically found in the broad ligament or mesosalpinx 2, 3, 4.
- Ovarian cysts, on the other hand, originate from the ovary itself.
- Paraovarian cysts can be difficult to distinguish from ovarian cysts on ultrasound, but may be identified by their extraovarian location and characteristic appearance 2, 4.
- The diagnosis of paraovarian cysts is often established on ultrasound, but may require additional imaging modalities, such as MRI, to confirm the diagnosis 3.
- Paraovarian cysts are usually asymptomatic and benign, but may cause symptoms such as abdominal pain or infertility in some cases 5, 6.
Key Characteristics of Paraovarian Cysts
- Typically appear as simple cysts on ultrasound 2
- May have internal echoes due to hemorrhage 2
- Usually asymptomatic and benign, but may be malignant in rare cases 2, 5
- May cause complications such as adnexal torsion, hemorrhage, or rupture 5
Importance of Differentiation
- Differentiating paraovarian cysts from ovarian cysts is crucial for optimal management and treatment 5, 6
- Laparoscopic approach and fertility-sparing surgery may be considered in the management of paraovarian cysts 5, 6
- Accurate pre-operative diagnosis is essential to ensure optimal outcome for patients with adnexal masses 6