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We present a case of a totally independent cyst floating freely in the pouch of Douglas. This cystic structure was incidentally found during laparoscopy in a 50-year-old woman whose ultrasound scan suggested an ovarian cyst or a possible hydrosalpinx. The cyst was removed and was histologically identified as a benign cystic mesothelioma, which in itself is an extremely rare tumour that presents in the form of solitary or multiple peritoneal cysts attached to serous membranes. In our case the cyst was completely unattached and in this regard represents the first report of a solitary unattached free floating benign cystic mesothelioma found in the pouch of Douglas.

Benign cystic mesothelioma presenting as a solitary non–attached cyst in the pouch of Douglas