Paraovarian cyst

Paraovarian cysts (POCs) are remnants of Wolffian duct in the mesosalpinx that do not arise from the ovary. They account for ~10-20% of adnexal masses 3-4.

They typically occur in women at the ages of 20-40 years old.

Most are asymptomatic, although patients with large lesions can present with pelvic pain.

They usually occur around the broad ligament and arise from paramesonephric, mesothelial, or mesonephric remnants. They are usually simple cysts (although some authors include paraovarian cystadenomas under the umbrella of paraovarian cysts).

A paraovarian cyst is easier to recognise if the ipsilateral ovary is demonstrated to be separate from it. 

  • typically thin-walled and smoothly marginated
  • most often appear as unilocular 'simple' cysts (in ~66%) and rarely as multilocular (~4%)
  • a soft tissue nodule in the cyst may indicate the development of a neoplasm (rare) 9

Often seen located close to the ipsilateral round ligament and are often of homogenous signal intensity. 

In uncomplicated cases, signal characteristics usually follow that of fluid 12.

  • T1
    • hypointense
    • can be hyperintense if complicated by haemorrhage
  • T2
    • hyperintense

Other features include

Paraovarian cysts occasionally can be complicated by rupture, torsion, or hemorrhage. Large or symptomatic cysts often undergo surgical resection. Smaller asymptomatic ones are treated conservatively. 

For simple paraovarian cysts with no suspicious features on ultrasound, follow-up recommendations are the same as for ovarian cysts. According to a consensus statement by the Society of Radiologists in Ultrasound 13, follow-up is recommended for cysts that are:

  • 5 to 7 cm in a woman of reproductive age
  • 1 to 7 cm in a postmenopausal woman

Irrespective of age, cysts larger than 7 cm warrant further evaluation (with MRI) or surgical review.

Paraovarian cysts are also sometimes referred to as paratubal cysts or hydatid cysts of Morgagni 14,

For an adnexal cystic lesion consider:

Ultrasound - gynaecology
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Article information

rID: 13384
System: Gynaecology
Synonyms or Alternate Spellings:
  • Paratubal cyst
  • Paraovarian cysts
  • Parafimbrial cysts
  • Paratubal cysts
  • Paraovarian cyst (POC)
  • Paraovarian cyst
  • Hydatid cyst of Morgagni
  • Hydatid cysts of Morgagni
  • Parafimbrial cyst
  • Para-ovarian cysts
  • Hydatid of Morgagni
  • Hydatids of Morgagni
  • Paratubal cyst
  • Paraovarian cyst

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