A diagnostic challenge of a giant Para-ovarian cyst in an adolescent girl in a low resource setting- a case report

Introduction and importance: Presentation of a giant para-ovarian cysts is rarely reported in the literature, with varying symptoms, methods of treatment, and complications. Herein, we highlight the diagnostic challenges faced in a low resource setting in the diagnosis of a giant para-ovarian cyst in a 17-year-old girl. Case presentation: A 17-year-old, virginal girl who presented with vague abdominal pain with an abdomino-pelvic mass of about 24 weeks pregnancy uterus size was diagnosed as a case of huge benign ovarian cyst with normal tumour markers. A computed tomography showed a large well defined clear cystic lesion (19x23 cm) in the abdomino-pelvic region, and normal tumour markers. Clinical discussion: During exploratory laparotomy, the mass was found to be a giant para-ovarian cyst arising from right side, with normal bilateral tubes, ovaries and uterus. She underwent successful excision of the cyst with the laparotomy incision, with an uneventful postoperative recovery. Conclusion: In a resource constraint setting, preoperative differentiation of a giant para-ovarian cyst from an ovarian cyst is a real challenge. Operating gynaecologists needs to be aware of the possibility of giant paraovarian cysts in women with a huge abdomino-pelvic mass with normal tumour markers, and plan the treatment accordingly.