Paraovarian

Paraovarian refers to structures or conditions located near the ovary within the broad ligament, but distinct from the ovarian parenchyma. The term is commonly used in gynecology to describe paraovarian cysts, benign cystic lesions that arise from remnants of the Wolffian (mesonephric) duct. These cysts are typically discovered in women of reproductive age, though they can occur at any age.

Most paraovarian cysts are asymptomatic and found incidentally during imaging or surgery. When symptoms occur, they may include pelvic fullness, intermittent lower abdominal pain, or discomfort due to mass effect. Rare complications include torsion of the cyst, rupture, or infection.

Diagnosis begins with pelvic ultrasound, which shows a simple, thin-walled cyst located in the broad ligament adjacent to the ovary, usually with clear content and without solid components. Distinguishing a paraovarian cyst from an ovarian cyst can be challenging on imaging; MRI can aid in assessment. Definitive diagnosis is often made surgically, when the cyst is removed and its relation to the ovary confirmed.

Management depends on symptoms and dynamics. Asymptomatic and small paraovarian cysts may be managed with careful observation and periodic imaging. Symptomatic, enlarging, or indeterminate cysts are typically treated with surgical excision, most often by laparoscopy. The goal is complete cyst removal while preserving ovarian tissue; cystectomy is preferred when feasible, or salpingo-oophorectomy if necessary in older patients or when malignancy cannot be excluded.

Prognosis after complete excision is excellent; recurrence is uncommon. Malignant transformation is rare.