Giant nabothian cysts are extremely rare and may be misdiagnosed as other uterine tumors, adnexal masses or malignancies. A 43-year-old multiparous woman was admitted to our department with recurrent lower abdominal pain, urinary frequency, and a history of seconder amenorrhea for 3 months. She had not experienced systemic disease or major surgery, except cervical cyst aspiration and ablation three times in 2 years. Speculum examination revealed a bulge-like lesion and erosion on the anterior aspect of the cervix. Transvaginal ultrasonography revealed a 10×7 cm cystic mass between the uterus and bladder extending from the adnexa to the abdominal cavity. PAP smear revaled no malignancy or intraepithelial lesion. A 104x102x67-mm cystic mass with thick wall and septations extending from the cervix was observed in abdominal tomography. After initial assessment, diagnostic vaginal approach was planned. Cyst was totally excised and a Foley catheter balloon filled with 50 mL saline was inserted into the cavity remained after excision. Saline in the catheter decreased day by day and on postoperative day 4, the catheter was removed and the patient was discharged without any complications. Pathological evaluation showed that the retention cyst wall was lined by ciliated columnar epithelium without atypia and demonstrate tall, basally situated nuclei with apical mucin production, which verified the diagnosis of nabothian cyst. No evidence of dysplasia or malignancy was observed. At 6-month and first year follow-up, pelvic examination and magnetic resonance imaging revealed a normal cervix, without any evidence of recurrent nabothian cysts.
Anahtar Kelimeler: adnexal mass, nabothian cyst, pelvic mass