Cysts of this kind are regarded by Doran and others as originating in the hilum of the ovary, and therefore as springing from the remains of the Wolftian body. They form large multilocular tumours with glairy colloid contents like those already described. Instead of a glandular tissue in their walls from which the cysts form, there is a papillary growth into the cavities of the cysts. The intra-cystic growth consists of dendritic papillae covered with cylindrical epithelium which does not take the goblet characters.

This form of cystoma is sometimes combined with the other, as if the new-formation had originated from both parts of the ovary.

The papillomatous cyst has much more malignant characters than the ordinary colloid form. The growing papillae not infrequently pierce the wall of the cyst and present themselves externally. There may be thus a considerable shaggy growth outside the tumour. Then there may be, in addition, transplantation to other parts of the peritoneum, and the papillae grow where they are planted. We may in this way have shaggy papillomatous growths surrounding the uterus and other structures in the pelvis and even on the general peritoneum. The rupture of the cysts by scattering the papillae produces similar results.

This form of tumour is likely to be less pedunculated than the former kind. Originating at the hilum, it may grow specially into the broad ligament, distending it and stretching the Fallopian tube, somewhat in the fashion of the cysts of the broad ligament. There are, indeed, cases in which it is difficult to say whether the cyst has originated in the ovary or broad ligament.