Journal of Ultrasound in Medicine, Vol 17, Issue 9 551-555, Copyright © 1998 by American Institute of Ultrasound in Medicine
Sonographic features of ovarian remnants
A. C. Fleischer, D. Tait, J. Mayo, L. Burnett and J. Simpson
Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2675, USA.
Ovarian remnants occur after a portion of ovarian tissue is left behind
unintentionally after oophorectomy. The ovarian remnant may be functional
and cystic, producing pelvic pain and, in some patients, extrinsic
compression of the distal ureter. Ovarian remnants frequently are
associated with adhesions from previous pelvic surgery for endometriosis or
pelvic inflammatory disease. Ovarian remnants also may be included within
pelvic peritoneal inclusion cysts. In this retrospective study, the
sonographic features of ovarian remnants in 10 patients with surgical proof
or clinical follow-up data are described. Most ovarian remnants were simple
cysts (seven of 10), three had multiple septations, and six had a rim of
presumably ovarian tissue with arterial and venous flow. Three patients
with ovarian remnant masses that were aspirated had symptomatic relief
without recurrence. In one patient, guided aspiration was unsuccessful,
probably owing to the presence of organized hemorrhage within the mass.
Extrinsic compression of the distal ureter was observed in one patient, who
was treated with gonadotropin releasing hormone agonist (Lupron). The
sonographic findings of a completely cystic or multiseptated pelvic mass
with a rim of vascularized solid tissue in a postoophorectomy patient,
although such cases are rare, suggest the diagnosis of an ovarian remnant.
If the diagnosis can be established with a high degree of certainty,
sonographically guided aspiration may be attempted in an effort to provide
symptomatic relief. Otherwise, sonography is useful in serial assessment of
these masses in patients receiving medical treatment.
