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Surgical/Imaging

(87) Para-Tubal Cysts and Their Associations with Adnexal Torsion and Obesity

Thursday, April 3, 2025
3:50 PM - 5:00 PM ET
Location: Harbour Ballroom

    Primary Author(s)

  • Anat From, MD (she/her/hers)

    Clinical Fellow
    Department of Surgery, CHEO, Faculty of Medicine, University of Ottawa
    Ottawa, Ontario, Canada

    • Presenting Author(s)

  • Anat From, MD (she/her/hers)

    Clinical Fellow
    Department of Surgery, CHEO, Faculty of Medicine, University of Ottawa
    Ottawa, Ontario, Canada

    • Senior Author(s)

  • Tania Dumont, MD, FRCSC (she/her/hers)

    Associate Professor, University of Ottawa
    Department of Surgery CHEO, Faculty of Medicine University of Ottawa
    Ottawa, Ontario, Canada

    • Co-Author(s)

  • NF

    Nathalie Fleming, MD, FRCSC

    Professor, Dept of Ob/Gyn uOttawa
    Department of Surgery CHEO, Faculty of Medicine University of Ottawa
    Ottawa, Ontario, Canada

  • GS

    Gali Shapira Zaltsberg, MD

    Assistant Professor
    Medical Imaging Department, CHEO, University of Ottawa
    Ottawa, Ontario, Canada

  • HM

    Hirva Manek, MD, DNB, FRCR

    Clinical Fellow
    Medical Imaging, Children's Hospital of Eastern Ontario, Ottawa
    Toronto, Ontario, Canada

Background: Paratubal cysts (PTCs) are remnants of paramesonephric or mesonephric ducts, possibly androgen-sensitive, often misdiagnosed as ovarian cysts. Despite their clinical significance, their correlation with obesity, adnexal torsion and hyperandrogenism remains poorly understood.

Objective: To investigate the association between paratubal cysts (PTCs), adnexal torsion, and obesity in adolescents.

Methods: Retrospective cohort study of female patients aged 2-18 who underwent surgery for suspected benign adnexal lesions at a tertiary-level pediatric hospital between 2018 and 2024. Data on demographics, body-mass index (BMI), cyst characteristics, surgical outcomes, and androgen profile were collected.
REB approved.

Results: Of 124 patients, 43 (34.7%) had PTCs. Obesity was significantly associated with PTCs (p=0.002), with a relative risk of 2.2. PTCs were also associated with adnexal torsion (p < 0.001), with a relative risk of 2.4. This association remained significant even when comparing PTCs to dermoid cysts, which are traditionally considered to be the primary cause of adnexal torsions in the pediatric literature. A positive correlation was found between PTC volume and BMI.

Conclusions: PTCs are more common in obese adolescents and are strongly associated with adnexal torsion. This highlights the need for heightened awareness and careful evaluation of PTCs in obese patients to prevent complications like adnexal torsion.