Case Report: Successful laparoscopic approach for the management of a voluminous left paratubal cyst: two cases and a literature review.

INTRODUCTION

Paratubal or adnexal cysts develop in the broad ligament of the uterus. They are regarded as giant when the 150 mm threshold is reached. Clinical features and presenting symptoms include either the effects of compression of the adjacent organs or complications. Surgical resection of these cystic masses is required for diagnosis and treatment.

CASE PRESENTATION: We report the cases of two young women who complained of pelvic pain and progressive abdominal distension. Investigations indicated that paratubal cysts were compressing their adjacent structures. The medical staff's decision was to operate on these patients using a laparoscopic approach to provide histological confirmation and treat their symptoms. This decision was taken on the basis of the lack of morphological signs of benignity. Thus, the patients were managed via a laparoscopic approach to provide histological confirmation and symptom relief. The procedure was performed under a pneumoperitoneum of 12 mmHg with a specific strategy to prevent spillage.

DISCUSSION: A laparoscopic approach in the management of large paratubal cysts appears to be safe and feasible. However, expertise is required for the successful removal of the mass. The first challenge is to avoid spilling the cyst's contents, as there is no evidence of benignity, and the second is to preserve the ovaries and adnexa for fertility.

CONCLUSION

Cystic paratubal masses require comprehensive investigations to determine their nature and origin. However, only surgical resection can confirm the diagnosis, as it offers the possibility of histological confirmation. Moreover, a laparoscopic approach is also useful for treating the patient's symptoms. It is important to note, however, that the size of the cyst could limit the use of this approach; therefore, expertise is required.