Dechen Sonam, Dorji Namkha, Pradhan Birendra
Faculty of postgraduate medicine, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan.
Faculty of postgraduate medicine, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan; Department of Obstetrics and Gynaecology, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
Int J Surg Case Rep. 2025 Jan;126:110703. doi: 10.1016/j.ijscr.2024.110703. Epub 2024 Nov 29.
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.
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.
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.
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 para-ovarian cysts in women with a huge abdomino-pelvic mass with normal tumour markers, and plan the treatment accordingly.
巨大副卵巢囊肿的病例在文献中鲜有报道，其症状、治疗方法及并发症各不相同。在此，我们着重介绍在资源匮乏地区对一名17岁女孩诊断巨大副卵巢囊肿时所面临的诊断挑战。
一名17岁处女女孩，因腹部隐痛就诊，腹部盆腔肿物约24周妊娠子宫大小，肿瘤标志物正常，被诊断为巨大良性卵巢囊肿。计算机断层扫描显示腹部盆腔区域有一个边界清晰的大囊性病变（19×23厘米），肿瘤标志物正常。
在剖腹探查术中，发现肿物为右侧起源的巨大副卵巢囊肿，双侧输卵管、卵巢及子宫均正常。她通过剖腹手术切口成功切除囊肿，术后恢复顺利。
在资源有限的情况下，术前鉴别巨大副卵巢囊肿与卵巢囊肿是一项真正的挑战。妇科手术医生需要意识到，对于腹部盆腔肿物巨大且肿瘤标志物正常的女性，存在巨大副卵巢囊肿的可能性，并据此制定治疗方案。
