Introduction: Paraovarian cysts occur in the broad ligament between the ovary and the tube, predominantly arising from mesothelium covering the peritoneum (68%) but also arise from the paramesonephric tissue (30%) and rarely from mesonephric remnants (2%). In this report, the authors present successful laparoscopic management of a large paraovarian cyst of mesonephric origin. Case Report: A 30yearold P2L2 presented with oligomenorrhoea. On examination, BMI was 30Kg/m2, hirsutism was present. Per abdomen examination revealed a mobile, cystic mass corresponding to 20 weeks’ size.Ultrasonography of lower abdomen revealed a normal uterus and left adnexa and a mass of 11.6 x10 cm in the right adnexa. With a preoperative diagnosis of ovarian cyst in PCOS, she was taken up for laparoscopy, which showed a bulky left ovary and right ovarian cyst of 15x12cm with smooth wall and clear fluid. Histopathology revealed a mesonephric cyst. Conclusion: Physicians should maintain a high index of suspicion for this uncommon cyst which is often difficult to diagnose both clinically, radiologically and even intraoperatively. Large size should not deterr the physician in taking recourse to the laparoscopic approach,provided the benign nature has been determined preoperatively.

Keywords: Paraovarian; Mesonephric; Cyst; Laparoscopic; Rare.