A rare case of bilateral paraovarian cysts, giant on one side

Abstract

Paraovarian cyst is a type of adnexal cyst originating from the mesothelium in the broad ligament between the fallopian tube and the ovary; it accounts for 10% of all adnexal masses. They are considered giant when the threshold of 150 mm is exceeded. Only a few cases of giant paraovarian cysts (>20 cm) have been published, and all cases have had different approaches and histopathological types. The aim is to report a case of Bilateral paraovarian cyst in which one side cyst was giant, because of rarity to add to the literature. A 26-year-old nulligravida presented with mass per abdomen with no other associated complaints. She was taken for Exploratory laparotomy with subsequent bilateral paraovarian cyst aspiration with cyst excision. Frozen section sent to histopathology revealed benign serous cystadenoma. It draws clinical attention in the event of complications like cyst enlargement, torsion, rupture, haemorrhage and neoplasm. Age, gross appearance, size, septation, and Ca 125 levels are all weak indicators of malignancy. Hence, frozen sections should be checked intraoperatively to confirm the malignancy status, especially when there is a papillary projection. As a huge paraovarian cyst may mimic a large ovarian cyst hence it should be included in the differential diagnosis of pelvic masses, especially in the reproductive age.