Adolescent fallopian tube cysts (paratubal)

What are adolescent fallopian tube cysts (paratubal)?

While commonly occurring in older women, young girls and teenagers can also develop fallopian tube cysts. The two fallopian tubes are part of the reproductive system that transports the ova (egg) from the ovary (where eggs are produced) to the uterus (the womb) every month.

Fallopian tube cysts are fluid-filled sacs that often go undiagnosed and remain very small. The cysts are typically small (approximately 2 to 20 mm), but they can grow larger, can become >15 cm. Most paratubal cysts are benign (not malignant) and simple (one compartment).

What are the signs and symptoms of adolescent fallopian tube cysts (paratubal)?

Symptoms for large (over 4 cm) cysts include pain due to torsion. Small fallopian cysts typically don’t have symptoms.

• Fallopian tube rupture - The tube may leak if there is an extremely large or twisted cyst.
• Hemorrhage - Internal bleeding may occur if the cyst ruptures (rare).
• Pressure on internal organs - Giant cysts (approximately 10 to 15 cm) can push on the bladder, bowel, kidney or uterus. This pressure can lead to hydronephrosis (kidney swelling due to excess urine).
• Torsion (twist) - Sometimes the cyst will twist on its pedicle (the thin structure that connects the cyst to the body) causing severe pain, nausea and vomiting, and need for emergency surgery to preserve the tube and ovary on the affected side.

How are adolescent fallopian tube cysts (paratubal) diagnosed?

Fallopian tube cysts are diagnosed using pelvic imaging studies including:

• Ultrasound
• Magnetic resonance imaging (MRI)

What are the causes of adolescent fallopian tube cysts (paratubal)?

During development in the womb, all children have a Wolffian duct (the area where male sex organs are formed). The duct will shrink away as girls develop their female sex organs. If some remnants of the duct remain, the paratubal cysts will grow out from these areas. The cysts may also form out of the remnants of the paramesonephric or Müllerian duct (the area where the female sex organs are formed).

Risk factors

Endometriosis - Uterine endometrial cells grow outside the uterus, and can involve the ovaries forming cysts called “endometriomas".

How are adolescent fallopian tube cysts (paratubal) treated?

Treatment for fallopian tube cysts depends on your daughter’s symptoms as well as the size of the cyst.

• Watchful waiting with follow-up ultrasounds if your daughter has no complaints and the cyst is found to be small
• Surgery to remove the cyst should the cyst be large or your daughter be symptomatic. This is often done in a minimally invasive manner (laparoscopy).