More than meets the eye: a giant cervical polyp masquerading as an adnexal cyst.

A sexually inactive nulliparous woman in her early 30s presented with persistent pain in the left iliac fossa that had lasted for two years, intensifying over the past two months. An initial ultrasound suggested the possibility of a left adnexal cyst, which prompted treatment with oral contraceptives for months; however, her symptoms continued unabated. Subsequent pelvic MRI revealed a multiloculated cystic lesion, which was suspected to arise from the cervix. After robust counselling and consent, an examination under anaesthesia revealed a pedunculated cervical mass, which was excised and later confirmed via histopathological analysis as a giant endocervical polyp and hence an unnecessary scar abdomen was avoided. This case highlights the diagnostic challenges posed by the benign cervical lesions that can mimic adnexal pathology, especially when per speculum examination cannot be done, and it emphasises the critical need for correlation between imaging results, clinical evaluations and operative findings to avoid diagnostic delay and unwarranted radical surgeries.