A Giant Mesenteric Cyst in a Prepubertal Girl Mimicking an Ovarian Mass: A Case Report

Mesenteric cysts are rare benign intra-abdominal lesions in children, often presenting with nonspecific symptoms and posing diagnostic challenges. Their clinical and radiological resemblance to ovarian or paraovarian pathologies may lead to misdiagnosis, especially in female patients. We report the case of an eight-year-old premenarchal girl who presented with chronic abdominal pain and a palpable abdominopelvic mass. Imaging studies revealed a large multiloculated cystic lesion suggestive of a paraovarian cyst or serous cystadenoma. An exploratory laparotomy uncovered a giant mesenteric cyst measuring approximately 12 cm, adherent to the jejunal wall. Due to dense adhesions, complete cyst enucleation was not feasible, and segmental bowel resection with anastomosis was performed. Histopathology confirmed a benign mesenteric cyst. The patient had an uneventful postoperative recovery and remained asymptomatic during follow-up. This case highlights the diagnostic dilemma posed by mesenteric cysts in paediatric patients and emphasizes the importance of surgical exploration for definitive diagnosis and treatment. Early recognition and timely management result in excellent outcomes.