SONOGRAPHIC FEATURES OF OVARIAN REMNANTS

Ovarian remnants occur after a portion of ovarian tissue is left behin d unintentionally after oophorectomy. The ovarian remnant may be funct ional and cystic, producing pelvic pain and, in some patients, extrins ic compression of the distal ureter. Ovarian remnants frequently are a ssociated with adhesions from previous pelvic surgery for endometriosi s or pelvic inflammatory disease. Ovarian remnants also may be include d within pelvic peritoneal inclusion cysts. In this retrospective stud y, the sonographic features of ovarian remnants in 10 patients with su rgical proof or clinical follow-up data are described. Most ovarian re mnants were simple cysts (seven of 10), three had multiple septations, and six had a rim of presumably ovarian tissue with arterial and veno us flow. Three patients with ovarian remnant masses that were aspirate d had symptomatic relief without recurrence. In one patient, guided as piration was unsuccessful, probably owing to the presence of organized hemorrhage within the mass. Extrinsic compression of the distal urete r was observed in one patient, who was treated with gonadotropin relea sing hormone agonist (Lupron). The sonographic findings of a completel y cystic or multiseptated pelvic mass with a rim of vascularized solid tissue in a postoophorectomy patient, although such cases are rare, s uggest the diagnosis of an ovarian remnant. If the diagnosis can be es tablished with a high degree of certainty, sonographically guided aspi ration may be attempted in an effort to provide symptomatic relief. Ot herwise, sonography is useful in serial assessment of these masses in patients receiving medical treatment.