Found a growth near your ovary? Discover what a paraovarian cyst really means for your health.

You might visit your doctor for a routine checkup or get an ultrasound scan for an unrelated reason, only to find out there is a small fluid-filled sac near your ovary. Hearing about a growth near a reproductive organ can feel scary and overwhelming at first. Before you worry, let us look at the facts and understand what this means.

Today, we will talk about a very common and usually harmless condition called a paraovarian cyst. Understanding what this is can help ease your mind and guide you on what steps to take next.

What is a Paraovarian Cyst? Simply Put...

The name itself explains a lot about where this cyst is located and what it looks like.

• "Para" means close to or nearby.
• "Ovarian" refers to your ovary.
• "Cyst" means a sac filled with fluid or a mix of fluid and solid material.

A paraovarian cyst is a fluid-filled sac that forms very close to your ovary, rather than inside or directly on the ovary itself. This makes them different from typical ovarian cysts.

Sometimes, if these cysts form close to your fallopian tubes, doctors call them paratubal cysts. Another specific type includes hydatid cysts of Morgagni. These form on the tiny finger-like projections at the end of your fallopian tubes called the fimbriae. The fimbriae catch the egg when it releases during ovulation.

The most important thing to know is that most paraovarian cysts are completely harmless and rarely cause noticeable symptoms.

How Common Are Paraovarian Cysts?

Paraovarian cysts make up about 5% to 20% of all masses found around the uterus and ovaries. However, finding the exact number is difficult because many people have them without ever knowing it.

Because these cysts rarely cause symptoms, they often go unnoticed unless discovered during an unrelated medical scan. They can form at any age, but doctors most commonly find them in women between 20 and 40 years old during their reproductive years.

What Are the Symptoms?

In most cases, paraovarian cysts cause no symptoms at all. When symptoms do appear, it is usually because the cyst has grown large enough to press against other organs inside your lower belly.

This pressure can cause a dull ache, a feeling of heaviness, or a slow pinching sensation in your lower abdomen. Sometimes, you might even feel a sharp pain if the pressure increases.

Can a Paraovarian Cyst Cause Pain?

Yes, a paraovarian cyst can cause pain, especially if it grows larger and presses against nearby pelvic organs. Without pain, you might still feel a sense of fullness, bloating, or general discomfort in your lower belly.

Why Do Paraovarian Cysts Form?

These cysts develop within the broad ligament, which is the supportive fold of tissue surrounding your reproductive organs like the ovaries and fallopian tubes. Most of these cysts form in the middle layer of this broad ligament.

Think about when you were developing as an embryo inside your mother. Your reproductive system formed from paired tubular structures called Müllerian ducts. As these organs developed, tiny leftover fragments from those ducts remained behind and later grew into cysts within the broad ligament.

Simply put, these cysts form from tiny leftover tissue remnants that were present even before you were born.

What Are the Complications?

If a paraovarian cyst causes no symptoms and poses no risk, it usually requires no treatment. However, complications can sometimes occur:

• Cyst Enlargement: Most paraovarian cysts measure between 1 and 8 centimeters across. They are harmless when small. On rare occasions, some can grow up to 20 centimeters wide. Large cysts press on pelvic organs, causing lower belly pain, constipation, or a frequent need to urinate. Larger cysts carry a higher risk of twisting or bursting.
• Cyst Torsion: Large cysts have a higher chance of twisting, known as torsion. When a cyst twists, it can cause severe lower belly pain, lower back pain, fever, and vomiting. Depending on where the cyst sits, the twist can also tangle the fallopian tube, cutting off blood and oxygen supply and causing permanent tissue damage.

• Cyst Rupture: A cyst can burst open, which may lead to internal bleeding and sudden sharp pain.
• Cancer Risk: This happens very rarely. The chance of a paraovarian cyst turning into cancer is extremely low. Even if a cyst contains solid tissue, it is almost always benign.

How Are Paraovarian Cysts Diagnosed?

Many people find out they have a paraovarian cyst during a pelvic exam or through an ultrasound scan. Ultrasound uses sound waves to create pictures of your pelvic organs and identify any growths.

If you have lower belly symptoms like pain or pressure from a large cyst, your doctor may recommend a transvaginal ultrasound. This uses the same sound wave technology, but the doctor inserts a small probe called a transducer gently into the vagina to get a closer, clearer view of your ovaries and nearby areas.

Sometimes, to check whether a cyst is simply fluid-filled or contains solid tissue, a doctor may need to remove and test it. However, your doctor will decide if that step is necessary. In most cases, further invasive testing is not needed.

How Are Paraovarian Cysts Treated?

Because most paraovarian cysts are harmless, they do not need treatment. On very rare occasions, if a cyst carries a risk of complications or a small chance of being cancerous, your doctor may remove it. Management and treatment options include:

• Expectant Management: This means watching and waiting without any follow-up care needed. Doctors choose this option when the cyst is harmless, symptom-free, and carries no risk of complications. This is the most common approach for paraovarian cysts.
• Surveillance: If your cyst is likely harmless but carries a slight risk of growing or changing, your doctor may suggest follow-up ultrasound scans or blood tests to monitor it over time.
• Surgery: If your cyst causes uncomfortable symptoms or carries a risk of complications, surgical removal is an option.

Surgical Methods.

Doctors most commonly use laparoscopic cystectomy to remove paraovarian cysts. During this procedure, the surgeon makes a few tiny cuts in your abdomen, inserts a tiny camera and delicate instruments, and removes the cyst. People often call this keyhole surgery.

What Can You Expect If You Have One?

You will likely find out about a paraovarian cyst by accident during an unrelated medical visit. Your doctor will let you know if you need to monitor the cyst or undergo further tests. For the most part, a paraovarian cyst is a harmless condition that will not disrupt your daily life.

Do These Cysts Go Away on Their Own?

Yes, many cysts disappear on their own without any problems. On rare occasions, some may grow larger or twist, in which case your doctor can remove them.

Can You Prevent Paraovarian Cysts?

Unfortunately, you cannot prevent these cysts from forming. The reassuring news is that they are low-risk growths that rarely cause trouble.

When Should You See Your Doctor?

Make sure to visit a gynecologist for a yearly exam once you turn 15 or become sexually active. If you notice any new symptoms, mention them to your doctor during your annual checkup. Even though a paraovarian cyst is usually harmless, your doctor can confirm that you face no risk of complications.

When Should You Go to the Emergency Department?

As mentioned earlier, if a cyst twists, it becomes a medical emergency. You must seek professional medical help right away if you experience:

• Sudden, sharp pain in your lower belly.
• Pain starting in your lower back and spreading outward.
• Severe pain accompanied by dizziness or a feeling that you might vomit.

If you experience these symptoms, do not wait. Go to the nearest hospital emergency department right away.

Ovarian Cysts vs. Paraovarian Cysts: What is the Difference?

Paraovarian cysts form near the ovary rather than on or inside it. However, ultrasound scans can sometimes make both types of cysts look similar. They often cause similar symptoms, share similar risks of complications, and doctors may remove them using similar surgical methods.

Still, a few key differences exist.

Ovarian cysts often develop in response to hormonal changes in your body. However, paraovarian cysts do not respond to hormones. Some studies also suggest that paraovarian cysts have a higher chance of twisting compared to standard ovarian cysts.

Are Paraovarian Cysts Cancerous?

They can be, but that is extremely rare. Only a very small number of cases report paraovarian cysts turning into cancer.

If your doctor discovers a paraovarian cyst on an ultrasound scan, do not panic right away. The cyst likely formed from tissue remnants left over from when your reproductive system developed before birth. In most cases, it is harmless. Your doctor will advise you on whether you need to have it removed.