Paratubal Cysts, Polycystic Ovary Syndrome, and Obesity in Adolescence: A Retrospective Cohort Study [ID 1696]

INTRODUCTION: Paratubal cysts (PTCs) arise from Wolffian duct remnants, and thus have androgen receptors. Recent studies in adolescents show an association between PTCs and polycystic ovary syndrome (PCOS)-associated conditions like hyperandrogenism and obesity. A link with PCOS itself has not been demonstrated, and little is known about the chronology of these diagnoses. This study aims to address these gaps in the literature. METHODS: This is an IRB-approved observational cohort study of female adolescents, ages 10–21 years, diagnosed with a PTC on surgical pathology between January 1, 2014, and March 31, 2018. Age- and race/ethnicity-matched controls were assigned in a 3:1 ratio. Participants were assessed for existing or subsequent diagnoses of PCOS and PCOS conditions (acne, hirsutism, type 2 diabetes, prediabetes, or insulin resistance) over 5 years. RESULTS: A total of 64 adolescents with a PTC and 192 controls were identified. Median age at PTC diagnosis was 17.0 years (interquartile range 14.0–19.0). Girls with a PTC were more likely to be overweight/obese (64.1% versus 46.2%, P =.01) and have PCOS (20.3% versus 4.7%, P <.001) compared to controls. There were no significant differences in rates of PCOS-associated conditions or time to diagnosis between the two groups. Girls with PTC who were overweight/obese were more likely to have PCOS than those who were underweight/normal weight ( P =.002). CONCLUSIONS/IMPLICATIONS: This is the first study to demonstrate an association between PTC formation and PCOS. Our findings highlight an opportunity to screen for PCOS at the time of PTC diagnosis, especially among adolescents who are overweight/obese.