Unsuspected adnexal masses in renal transplant recipients

Post-transplant sonograms in 74 female recipients less than 40 years old revealed unsuspected adnexal masses in 5 (7 per cent). Sonographically, these masses were difficult to distinguish from other post-transplant fluid collections, such as lymphoceles, urinomas or abscesses and, consequently, led to further diagnostic evaluations in 4 patients. Of the adnexal masses 4 were excised surgically: 2 were hemorrhagic ovarian cysts, 1 was a follicular ovarian cyst and 1 was a paraovarian cyst. A coexisting gynecologic mass should be included in the differential diagnosis of a perinephric mass in female transplant recipients. Pre-transplant sonograms to identify or exclude occult pelvic masses in women may be of benefit in simplifying the postoperative management and minimizing unnecessary diagnostic evaluation.