• Jiao Wen, Yun Zhao, Fei Tang, Wenxing Cheng, Jing Peng, Qianyi Li, Haotian Pan, Hao Li, and Lei Chen.
• Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
• Medicine (Baltimore). 2024 Mar 8; 103 (10): e36979e36979.

RationaleRetroperitoneal benign cysts during pregnancy are extremely rare and often remain asymptomatic until they attain a very large size. Diagnosis typically relies on a pathological tissue biopsy. The decision to pursue 1-step or 2-step surgical treatment should be tailored to each individual case rather than generalized.Patient ConcernsThis case report presents the unique scenario of a pregnant woman with a confirmed pregnancy complicated by a large retroperitoneal cyst. The patient had a retroperitoneal cyst during her initial pregnancy, which went undetected during the first cesarean section. However, it was identified during her second pregnancy by which time it had grown to 13.0 cm × 15.0 cm × 25.0 cm, and extended from the liver margin to right ovarian pelvic infundibulopelvic ligament. Consequently, it was removed smoothly during her second cesarean section.DiagnosesPostoperative pathology results indicated a massive retroperitoneal mucinous cystadenoma.InterventionsThe giant retroperitoneal cyst was smoothly excised during the second cesarean delivery for 1-step surgical treatment.OutcomesUnder the combined spinal and epidural anesthesia, a live female infant was delivered at 38 3/7 gestational weeks and the neonatal weight was 3200g. Under general anesthesia with endotracheal intubation, the giant retroperitoneal cyst was excised smoothly without complications.LessonsThe findings of this case report contribute to the understanding of the diagnostic modalities, surgical approaches and postoperative considerations of giant retroperitoneal cysts associated with pregnancy.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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