Antenatal diagnosis of a fetal ovarian cyst

Valenti, Catherine; Kassner, E. George; Yermakov, Valentin; Cromb, Ellen

doi:10.1016/0002-9378(75)90534-7

Cited by 81 publications

(36 citation statements)

References 2 publications

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“…Todate, the majority of prenatally diagnosed ovarian cysts reported in the litera ture have undergone surgery in the neonatal period. Despite the surgeon's intent of pre serving ovarian function, oophorectomy or salpingoophorectomy is the usual operation, because the cyst is either adherent to, or has replaced, normal ovarian tissue [1], Prenatal aspiration has previously only been per formed for remote complications of ex tremely large cysts such as hydramnios [ 13] or theoretical risks of pulmonary hypoplasia [14].…”

Section: Discussionmentioning

confidence: 99%

Fetal Ovarian Cysts: Diagnostic and Therapeutic Role for Intrauterine Aspiration

Meagher

Fisk²,

Boogert³

et al. 1993

Fetal Diagn Ther

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Antenatal diagnoses of fetal ovarian cysts have not usually been confirmed until postnatal surgery. We describe 2 cases of hemorrhage into fetal ovarian cysts in which cyst aspiration in utero allowed both confirmation of the diagnosis prenatally and obviated the need for neonatal surgery. In both cases, cytology of the cyst aspirate demonstrated luteinized granulosa cells and biochemistry showed estradiol levels of > 10,000 pmol/l, indicating ovarian etiology. Hemorrhage, which had been suspected on ultrasound, was confirmed by cytology, showing hemosiderin-laden macrophages. There was no evidence of recurrence in either case following aspiration. The described association of fetal hypothyroidism was excluded by testing thyroid function in cord blood and/or cyst aspirate. We suggest that intrauterine aspiration contributes to the management of fetal ovarian cysts by confirming their ovarian origin, demonstrating the presence or absence of hemorrhage and facilitating preservation of ovarian function both by reducing the risk of torsion and the need for neonatal surgery.

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Section: Discussionmentioning

confidence: 99%

Fetal Ovarian Cysts: Diagnostic and Therapeutic Role for Intrauterine Aspiration

Meagher

Fisk²,

Boogert³

et al. 1993

Fetal Diagn Ther

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“…1 With recent technologic advancements in prenatal sonography, fetal ovarian cysts have been detected more frequently. Ovarian and genital tract abnormalities constitute approximately 20% of all abdominal masses in the neonate.…”

Section: Case Presentationmentioning

confidence: 99%

Congenital ovarian cyst

Ibrahim

Lewis

Harrison³

et al. 2007

J Perinatol

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Case presentationFetal ovarian cysts were first described as a prenatal finding by Valenti et al. 1 in 1975 and were believed to be a rare finding. 1 With recent technologic advancements in prenatal sonography, fetal ovarian cysts have been detected more frequently. Ovarian and genital tract abnormalities constitute approximately 20% of all abdominal masses in the neonate.These cysts vary in size; they can be simple or complex, and are commonly unilateral. Intrauterine complications such as torsion and rupture may occur, and treatment options vary from conservative management to antenatal aspiration, early delivery and neonatal surgery. Nussbaum et al.3 thus categorized fetal ovarian cysts according to ultrasound criteria into two groups: simple (uncomplicated) and complicated. The sonographic features of uncomplicated cysts are anechogenic, round, >20 mm in diameter, unilocular, intrapelvic or more often intra-abdominal, unilateral or seldom bilateral, thin-walled, and more or less mobile with the mother's positions. Sonographic features of complicated cysts are heterogeneous with hyperechogenic components, thick-walled, containing free-floating material, with intracystic septations and mobile after adnexal torsion; the absence of color Doppler flow is 100% and therefore highly specific for torsion.We report a neonate with complicated congenital ovarian cyst and daughter sign who was diagnosed in utero.Case report A 4760 g female delivered via elective cesarean section for macrosomia with an estimated weight 5000 g to a 21-year-old gravida 3, para 1 mother. The baby's apgar scores were 8 and 9 at 1 and 5 min of life respectively. The baby was taken to the neonatal intensive care unit for further evaluation and observation. The maternal history was insignificant, blood type A-negative, rapid plasma reagin nonreactive, group B Streptococcus-negative, hepatitis B surface antigen-negative, and antibody screen-negative. Prenatal ultrasound (US) 1 week before delivery showed:A unilateral intra-abdominal cyst located slightly in the right lower quadrant, with thin septations, was detectedy Further evaluation confirmed female genitalia and normal-appearing fetal urinary and gastrointestinal (Figure 1).Physical examination on the first day of life was not remarkable, except for the presence of a mass in the right lower quadrant of the abdomen. This mass was described as being firm but not hard, with the consistency of a water-filled balloon, measuring 6 Â 3 cm, and was freely movable within the right lower quadrant.Abdominal X-rays revealed displacement of the small bowel to the left without evidence of mechanical obstruction (Figure 2). Formula was tolerated well and a transitional stool was passed. Surgical consultation was obtained, and the patient underwent two abdominal US (Figure 3) and magnetic resonance imaging (MRI) of the abdomen and pelvis which revealed right lower quadrant cyst with daughter's cyst sign. (Figure 4).Surgical exploration was performed. At the time of surgery, unilateral ovarian cyst measuri...

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“…The first sonographic diagnosis of ovarian cyst was reported in a living fetus in 1975 1 . Since then these cysts have been increasingly recognized in newborns as a result of being identified prenatally on ultrasound examination.…”

Section: The 'Daughter Cyst Sign': a Sonographic Clue To The Diagnosimentioning

confidence: 99%

“…Although not sensitive, the 'daughter cyst' sign seems to be highly predictive of the ovarian origin of female fetal intra-abdominal cysts. Three-dimensional transvaginal ultrasound provides clearer delineation of myometrial invasion in a patient with endometrial cancer and uterine leiomyoma Endometrial cancer in women aged 45 years or younger is uncommon, and is mainly characterized by low-grade disease localized to the endometrium 1 . It has been shown in one case that an infertile patient with Grade 1 endometrial cancer limited to the endometrium could be treated with conservative therapy and subsequently achieve a term pregnancy 2 .…”

Section: The 'Daughter Cyst Sign': a Sonographic Clue To The Diagnosimentioning

confidence: 99%

The ‘daughter cyst sign’: a sonographic clue to the diagnosis of fetal ovarian cyst

Quarello

Gorincour

Merrot

et al. 2003

Ultrasound in Obstet & Gyne

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Antenatal diagnosis of a fetal ovarian cyst

Cited by 81 publications

References 2 publications

Fetal Ovarian Cysts: Diagnostic and Therapeutic Role for Intrauterine Aspiration

Fetal Ovarian Cysts: Diagnostic and Therapeutic Role for Intrauterine Aspiration

Congenital ovarian cyst

The ‘daughter cyst sign’: a sonographic clue to the diagnosis of fetal ovarian cyst

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