Background: Paraovarian cysts arise from the mesothelium lining of remnants of the Müllerian duct and Wolffian duct. They are mostly small and asymptomatic; however, torsion may occur in larger lesions.
Case: A seventeen years old girl complained of acute abdominal pain. C.T. scan was arranged which revealed a large adnexal mass 82 x 63 mm. Doppler ultrasound showed absent blood flow to the adnexal mass. Laparoscopy revealed a large right torsion and gangrene in a paraovarian cyst and right salpingo-oophorectomy was done via laparoscopy.
Conclusion: Laparoscopy is preferred over laparotomy in the management of torsion of paraovarian cysts as it is associated with shorter hospital stay and less patient discomfort. Salpingo-oophorectomy should be reserved for late gangrenous cases.