A Cystic Surprise: Unearthing Fimbrial Cysts as an Uncommon Source of Abdominal Pain

Fimbrial cysts also known as paraovarian cysts are small and asymptomatic and are occasionally large resulting in pelvic pain. It is difficult to differentiate a fimbrial cyst from an ovarian cyst by imaging; therefore, they are often recognized intra-operatively during laparotomy. This report presents a rare case of a 48-year-old female who presented with the primary complaints of persistent right lower abdominal pain that was intermittently radiating to the back for one year. Clinical findings reported the possibility of twisted right hydrosalpinx but the tumor biomarkers were found to be within the normal range. In addition to this, ultrasound sonography (USG) and magnetic resonance imaging (MRI) revealed a pelvic mass that was indicative of cystic lesions. As the above-mentioned diagnosis was found to be challenging, exploratory laparotomy as a part of surgical intervention and diagnosis was performed along with histopathological investigations that confirmed the existence of fimbrial end cysts on both sides. Fimbrial end cysts represent a rare yet significant cause of abdominal pain; therefore, early recognition, thorough clinical evaluation, and appropriate diagnostic workup are essential for timely intervention and preventing potential complications associated with fimbrial end cysts.