# Case Report of a Large Ovarian Cyst in a Multiparous Woman: A Challenging Surgical Management

## TL;DR

A 42-year-old woman with a large ovarian cyst underwent surgery to remove the affected ovary, chosen over a less invasive option due to her age and cyst characteristics.

## Contribution

Highlights the decision-making process in choosing between cystectomy and salpingo-oophorectomy based on patient-specific factors.

## Key findings

- Right salpingo-oophorectomy was performed instead of cystectomy due to patient age, completed childbearing, and cyst complexity.
- Histopathology confirmed the cyst was benign, supporting the decision for definitive surgery.
- Tailoring surgical choices to individual patient factors can optimize clinical outcomes.

## Abstract

This case report details the surgical management of a large (15 × 9 cm) symptomatic right ovarian cyst in a 42‐year‐old multiparous woman, highlighting the decision‐making process for definitive treatment. The patient presented with chronic pelvic pain and a palpable mass, significantly reducing her quality of life. Imaging revealed a large, multilocular, benign‐appearing cystic lesion. Given the patient′s age, completion of childbearing, and the cyst′s size and complexity, a right salpingo‐oophorectomy was performed instead of a cystectomy to achieve definitive symptom resolution and mitigate recurrence risk. The decision to proceed with a definitive right salpingo‐oophorectomy, rather than an ovarian cystectomy, was based on a confluence of factors: the patient′s age (42), her status as a multiparous woman who had completed childbearing, and the cyst′s size and complex multilocular morphology which increased the technical difficulty and potential morbidity of cystectomy while raising a low‐grade concern for underlying neoplasia. The surgery was uncomplicated, and histopathology confirmed a benign cystadenoma. This case underscores the importance of tailoring surgical intervention, specifically the choice between cystectomy and salpingo‐oophorectomy, to individual patient factors such as parity, fertility goals, and cyst characteristics to optimize clinical outcomes.