Fetal-Neonatal Ovarian Cysts-Their Monitoring and Management: Retrospective Evaluation of 20 Cases and Review of the Literature

Abstract

Objective: Neonatal ovarian cysts (NOC) are usually self-limiting structures. However, large or complex cysts may lead to severe complications. A standard guide to management, treatment and follow-up of NOC is not yet available. The aim of this study was to evaluate retrospectively the records of NOC patients from two medical centers.Methods: A total of 20 newborns with NOC were included in the study. The size and localization of the cyst, the age, the signs and symptoms at presentation, and the possible maternal and fetal-neonatal etiologic factors were recorded. Follow-up procedures and treatment modalities were evaluated. Results: The mean age at diagnosis was 34 gestational weeks. The cysts (mean size 53±15 mm) were predominantly in the right ovary (75%) and were evaluated as large cysts in 16 (80%) of the patients. In 5 of the patients with large cysts and in 1 of the 4 patients with small cysts, the cysts were evaluated as complex cysts. Torsion of the ovary was detected in five (25%) cases and these cases were treated surgically. Patients with simple cysts were closely followed by ultrasonography until the cysts disappeared. Conclusion: To date, there is no precise guide for the monitoring and treatment of NOCs. Surgical treatment should always be performed in a way to protect the ovaries and to ensure future fertility. In our NOC series, it has been possible to apply a non-invasive follow-up program and minimally invasive surgical procedures.Conflict of interest:None declared.

Fetal ovarian cyst mimicking a CSF pseudocyst in the setting of shunt failure

“…5 The exact etiology of these cysts is not known, but their pathogenesis is likely endocrinological in origin. As reviewed by Akın et al, 1 there is an increased incidence of fetal ovarian cysts among pregnancies complicated by diabetes, preeclampsia, and Rhesus factor incompatibility, attributed to the increased levels of placental chorionic gonadotropin levels that accompany these conditions. Furthermore, fetal hypothyroidism, congenital adrenal hyperplasia, and ovarian hyperstimulation observed in premature infants have been implicated in ovarian cyst formation.…”

Conservative Management of a Large Neonatal Ovarian Cyst: A Case Report

“…Simple small asymptomatic cysts showing no rapid growth can be monitored by serial USG during the pre and postnatal period [7], but as our case was asymptomatic throughout and serial USG monitoring was available with parental willingness of follow up, baby was managed conservatively.…”

“…Current consensus is based on anecdotal experiences and case series, which suggest conservative management of small simple cyst and operative management for complex cysts. Treatment of a large simple cyst remains controversial [7].…”

Autoamputated Fetal Adnexal Torsion Presenting as a Floating Abdominal Mass: Report of Two Cases

“…The literature suggests that simple neonatal ovarian cysts tend to spontaneously regress (6,9). Frequent ultrasonography follow-up and close monitoring for intestinal obstruction are mandatory in this approach.…”

“…The percutaneous aspiration technique for infant ovarian cysts has been proposed by radiologists as a minimally invasive and safe technique. However, the remnant of the cyst wall left in the abdomen still poses a potential threat for intestinal adhesion and volvulus, and cyst recurrence is frequent (8,9).…”