A Giant Paraovarian Cyst Misdiagnosed as a Distended Bladder: A Case Report

Paraovarian cysts (PCs) are uncommon adnexal lesions that often present with nonspecific or absent symptoms, making clinical diagnosis challenging. When they exceed 150 mm in size, they are referred to as giant paraovarian cysts, a rare condition. This article presents the case of an asymptomatic 22-year-old woman with a large pelvic mass, incidentally discovered during physical examination by her family doctor. An abdominal ultrasound was requested, and the first diagnosis was a "severely distended bladder." The patient was referred to urology, where a neuroaxis magnetic resonance imaging (MRI) and a urodynamic study were performed, both of which turned out to be normal. Due to the inconsistency of findings, the family doctor, who was closely following the case, requested an abdominopelvic computed tomography (CT) scan, which revealed a large mass, possibly an "abdominopelvic ovarian cyst or borderline tumor." The patient was referred to gynecology and underwent pelvic MRI. At last, a final diagnosis was made: a giant paraovarian cyst. The cyst was drained via diagnostic and curative laparotomy, followed by a quick recovery of the patient. The histopathological analysis confirmed a serous cystadenoma. This case highlights the importance of a thorough physical examination and considering gynecologic etiologies in the differential diagnosis of pelvic masses, even in asymptomatic patients.