Abstract
A 17-year-old woman had undergone exploratory laparotomy because of a huge cystic pelviabdominal mass equivalent of 36 weeks' gestation. A closed system drainage maneuver was applied via using a laparoscopic trocar to drain a revealed large left paraovarian cyst. This maneuver was found to be a simple and effective method to safely aspirate giant paraovarian cysts; thus allowing their total excision.
Highlights
Paraovarian cysts occur in the broad ligament between the ovary and the tube, predominantly arising from mesothelium covering the peritoneum and occasionally arise from the paramesonephric tissue and rarely from mesonephric remnants[1]
We present how we surgically managed a case with an abnormally huge paraovarian cyst
The left broad ligament was opened and the cyst wall was completely removed from the broad ligament (Figure 1)
Summary
Paraovarian cysts occur in the broad ligament between the ovary and the tube, predominantly arising from mesothelium covering the peritoneum (mesothelial cyst) and occasionally arise from the paramesonephric tissue (paramesonephric cysts or Mullerian cysts) and rarely from mesonephric remnants (mesonephric cysts or Wolffian cysts)[1]. Some paraovarian cysts may reach a large size with possible complications like torsion and rupture[3]. These cysts are usually benign and rarely malignant[4,5]. The trocar was inserted through the center of the suture which was subsequently stretched to fit around the sleeve. This created a closed system to drain the cyst. The trocar was removed leaving its sleeve in place and suction drained eight liters of clear watery fluid. The collapsed cyst was found to be left paraovarian, which was exteriorized and the trocar sleeve was removed. The peritoneal fluid showed proteinaceous material entangling few lymphocytes and mesothelial cells with no evidence of malignancy
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