The ovarian remnant syndrome, a complication of bilateral salpingo-oophorectomy, has progressively received more attention in gynecological surgery literature, in recent years. The syndrome is manifested by pelvic pain, and a palpable or sonographic pelvic mass. In rare cases, patients may present with large masses. Cystic masses or carcinomas are reported to develop in some of the ovarian remnant syndromes after surgery.

We hereby present a 69-year-old white female, complaining of abdominal pain, an enlarging abdominal mass, pollakuria, and urinary incontinence with duration of 1 year, 25 years after bilateral salpingo-oopherectomy. Clinical and radiological evidence of a mesenteric cyst was discovered. The final pathological diagnosis was mucinous cystadenoma in an ovarian remnant. Curiously, this patient had no history of endometriosis, previous pelvic or abdominal surgery excl. hysterectomy, pelvic inflammatory disease, inflammatory bowel disease, dense pelvic adhesions, or difficulty encountered during the previous hysterectomy. This tumor is the largest among all other ovarian remnants published in the international literature.

Women with complaints of abdominal or pelvic mass and /or pain with a history of total abdominal hysterectomy- bilateral salpingo-oophorectomy must be searched carefully and it must be kept in mind that ovarian remnant syndrome can develop without predisposing potential risk factors.