CYSTADENOFIBROMA LIGAMENTI UTERI LATI LATERIS SINISTRI; CYSTIS PARATUBARIS MESONEPHRICUS LATERIS SINISTRI; THEIR INCIDENCE, DIAGNOSTIC CHALLENGE AND TREATMENT

Abstract

Broad ligament cystadenofibroma and paraovarian mesonephric cysts and other paraovarian masses are part of the adnexal pathology found in all age groups of females from fetuses to adult women, more commonly from 3rd to 5th decade. They all contain 10-20% of all adnexal masses. Paratubal cysts, including Hydatid cysts of Morgagni, are of paramesonephric origin, while paraovarian ones originate from Wolffian ducts. Borderline or malignant tumours occur in 2-3% of cases. Broad ligament cystadenofibroma is a rare entity with only few articles published, and scarce data concerning their incidence. Paratubal mesonephric cyst is more common than broad ligament cystadenofibroma but there is also no data on their incidence. This article presents a case of concomitant presence of paraovarian cyst and Broad ligament cystadenofibroma in a 19-year-old patient, with no history of pregnancies. The patient sought medical attention due to abdominal pain. Laboratory tests showed a reduction of haemoglobin and hematocrit values, tumour markers Ca 125 and CEA were within normal limits, bHCG was negative. Transvaginal ultrasound and color Doppler revealed cystic adnexal mass on the left side measuring 43 mm of dimension, and a small amount of fluid in Douglas pouch (Figure 1). Due to abdominal pain and reduction of haemoglobin values, laparotomy was indicated and extirpation in toto of the tumor was performed. The histopathology confirmed the benign nature i.e. paraovarian cyst and Broad ligament cystadenofibroma. The case is presented regarding to extremely rarity of Broad ligament cystadenofibroma, possible urgent conditions of paratubal mesonephric cyst, way of treatment and their diagnostic challenge.