Congenital ovarian cyst

Abstract

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...

A case series of congenital ovarian cyst in a Tertiary Care Hospital in Mumbai, India

“…The most common complication to arise in congenital ovarian cyst is development of torsion of the ovarian pedicle which forms 50 to 70% of all complications. [4,5] The remaining complications being haemorrhage, rupture, peritionitis secondary to inflammation, urinary tract obstruction, bowel obstruction, autoamputation and in rare case of sterile necrosis of the ovary. These congenital ovarian cysts are known to undergo spontaneous regression.…”

“…Such predictive markers on prenatal USG include length of the ovarian pedicle, size of the cyst, laxity of the ovarian and infundibular ligament, solitary or multiple cyst in the same ovary, unilateral or bilateral involvement, simple versus complex nature of cyst, presence /absence of increased vascularity or congestion of ovarian pedicle on colour doppler. [5] Torsion of ovarian pedicle does result in inflammatory process reflected by subtle rise in alpha foeto protein/carcinoembryonic antigen levels but they have not been found to be predictive in identifying development of complications in congenital ovarian cysts. The most important markers on prenatal ultrasonogram to predict a complication include size and eco pattern of the cyst.…”

A Case Series of Fetal-Neonatal Ovarian Cyst from a Tertiary Care Hospital

“…Literature survey revealed NOC also occurs in healthy mothers often. 11 Though serous cystadenomas constitute approximately 40% of all ovarian tumors occurring in the reproductive age group, 12 it is infrequent in the fetus. From the literature search, only three studies [3][4][5] have reported serous cystadenoma among the NOC.…”

Minimally Invasive Surgery for Congenital Abdominal Cystic Lesions in Newborns and Infants

“…The detection of CACL has risen dramatically with extended use of ultrasound examination (5). Furthermore, nowadays, the quality of available sonographic devices is much better; growing expertise allows for near-exact qualification of cystic lesions in terms of both origin and localization.…”