BACKGROUND: The differential diagnosis of unilocular intraabdominal cysts includes ovarian, gastrointestinal, urological, and lymphatic processes. They occur at all ages and can be benign or malignant. METHODS: We present a case of a 17-year-old female with asymptomatic abdominal distension. Ultrasonography (US) revealed a 20 x 21-cm unilocular cystic mass with smooth surface lining. Paracentesis was performed during diagnostic laparoscopy, recovering more than 7 L of clear fluid. The cyst and left adnex were completely removed laparoscopically and diagnosis of ovarian cystadenoma was made. The patient made a quick and uneventful recovery. CONCLUSIONS: In all cases of abdominal distension, US must be performed and a tumor marker profile consisting of AFP, LDH, testosterone, estradiol, and CA-125 must be established in order to differentiate between benign and malignant processes. When the latter is suspected, additional computerized tomographic scanning must be performed. In this case, a normal tumor marker profile and benign ultrasonographic appearance excluded the possibility of malignancy. Conventional treatment in these large cysts is laparotomy. We propose that complete laparoscopic drainage and extirpation should be the treatment of choice, regardless of cystic size.
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机译：背景：单眼腹腔内囊肿的鉴别诊断包括卵巢，胃肠道，泌尿系统和淋巴过程。它们发生在各个年龄段，可能是良性或恶性的。方法：我们介绍了一名无症状腹胀的17岁女性的病例。超声检查（美国）显示20 x 21厘米的单眼囊性肿块，表面光滑。腹腔穿刺术在诊断性腹腔镜检查期间进行，回收了超过7 L的透明液体。腹腔镜下将囊肿和左附件完全切除，并诊断出卵巢囊腺瘤。病人很快又康复了。结论：在所有腹胀病例中，都必须行超声检查，并建立由AFP，LDH，睾丸激素，雌二醇和CA-125组成的肿瘤标志物谱图，以区分良性和恶性过程。如果怀疑后者，则必须执行其他计算机断层扫描。在这种情况下，正常的肿瘤标志物分布和超声检查的良性表现排除了恶性肿瘤的可能性。这些大囊肿的常规治疗是剖腹手术。我们建议，无论囊肿大小如何，均应选择完全腹腔镜引流和根治术。
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