Pelvic pain with a persistent left ovarian cyst seen on previous ultrasound studies
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A well-defined round shaped unilocular cystic lesion is seen in the left adnexa measuring 40x40 mm. It shows fluid signal (hypointense on T1 and high signal on T2 weighted images), it has a thin wall with no evidence of fatty tissue, no internal septations or mural nodule could be seen and both ovaries are normal and separate from the cyst, the findings in favor of a paraovarian cyst.
Paraovarian cysts are remnants of Wolffian duct in the mesosalpinx that do not arise from the ovary. They account for ~10-20% of adnexal masses, most are asymptomatic, although patients with large lesions can present with pelvic pain.