A 53-year-old woman with abdominal pain and fullness

• Published in: Canadian Medical Association journal (CMAJ) Vol. 172; no. 2; p. 184
• Main Authors: Ray, Mihir, Bose, Bireswar, Honore, Louis
• Format: Journal Article
• Language: English
• Published: Canada CMA Impact Inc 18.01.2005; CMA Impact, Inc; Canadian Medical Association
• Series: Clinical Vistas
• Subjects: Abdominal pain; Abdominal Pain - etiology; Care and treatment; Case studies; Cysts - diagnostic imaging; Cysts - pathology; Diseases; Female; Humans; Intestines; Middle Aged; Mullerian Ducts - diagnostic imaging; Mullerian Ducts - pathology; Radiography, Abdominal; Retroperitoneal Space; Tomography, X-Ray Computed; Canada
• ISSN: 0820-3946; 1488-2329
• DOI: 10.1503/cmaj.1041453

Cystic lesions in the retroperitoneal space are uncommon. The majority are of lymphatic or enteric origin or are cystic neoplasms. Müllerian duct cysts are extremely rare in the retroperitoneum.1,2 In early embryonic life the gonadal system develops from 2 different ductal structures, known as müllerian and wolffian ducts. If the gonads develop into ovaries, the wolffian duct system atrophies, allowing the müllerian system to develop, with 1 duct on each side. Eventually the 2 ducts fuse to form the uterus, fallopian tubes and the upper part of the vagina. In the male the atrophied müllerian ducts remain as the prostatic utricle.3,4 If a small part of the embryonic duct separates as an anomaly and fails to regress, it can continue to grow and present as a cystic mass in infancy or adult life. Remnants are usually found in females in the broad ligaments and in males in the retrovesical space.3