Non-Tender Huge Abdominal Mass in an Adolescent: Bilateral paraovarian cysts

Abstract

Paraovarian cysts constitute about 10% of all adnexal masses in females and occur most commonly in the third and fourth decades of life. These cysts are benign and usually uncommon in adolescence. Such cysts pose a diagnostic challenge while distinguishing them from ovarian cysts clinically and during radiological investigations. We report a rare case of a 13-year-old female patient with bilateral paraovarian cysts, including a giant cyst in right mesosalpinx presenting to Sohar hospital, Oman in 2018. The definitive origin of the huge mass on the right side of abdominal cavity could not be established in the current case despite contrast enhanced computerized tomography. It was only on laparoscopic exploration that this mass was identified as a giant paraovarian cyst. Both the giant cyst and a smaller paraovarian cyst on the left side were enucleated with minimally invasive surgery while preserving the fertility of the patient. Only one other similar case of bilateral paraovarian cysts in an adolescent, including a giant cyst managed with laparoscopy, has been documented previously.

Keywords: Adolescent; Case Report; Laparoscopy; Minimally Invasive Surgical Procedures; Oman; Parovarian Cyst; Ultrasonography.

Figure 1

A contrast enhanced computerised tomography scan showing (A) a transverse view (measuring 20 cm) and (B) a craniocaudal view (measuring 23 cm) of the cystic lesion (arrows) in the abdomen of a 13-year-old female patient.

Figure 2

Intraoperative views showing a giant paraovarian cyst extending to a part of the ovary in a 13-year-old female patient. (A) The arrowhead points to the aspirated giant paraovarian cyst and the arrow points to the right fallopian tube. (B) The arrowhead points to the left ovary, the white arrow points to the right fallopian tube with ovary underneath and the black arrow points to the collapsed giant ovarian cyst.

Figure 3

Histopathology of a specimen obtained from the giant paraovarian cyst on the right side of the ovary at 100x magnification consistent with a diagnosis of a benign serous cystadenoma.