Ovarian cysts in newborns

Abstract

Before the introduction of ultrasonography (US), ovarian cysts in newborns were thought to be rare. With the extended use of real-time US, prenatal detection has increased. There is still considerable controversy regarding the best treatment of these neonatal findings. A total of 27 instances in 24 consecutive newborns of antenatally-diagnosed ovarian cysts were reviewed for US data, management, and outcome to assess the ante- and postnatal evolution of the cyst and establish appropriate therapy. The cysts detected during pregnancy were studied by repeated postnatal US studies. In 10 children (2 with bilateral cysts) the cyst evolved spontaneously toward regression. Fourteen patients were operated upon; 10 had complex and 4 (in 1 bilateral) had simple cysts. Cystectomy was employed when possible to preserve the ovarian parenchyma (3 cases); in the remaining cases oophorectomy was performed. Histologically, the cysts were of follicular origin or necrosis made a diagnosis impossible. US was found to be a helpful diagnostic tool for simple ovarian cysts, but could not reliably distinguish between benign and malignant tumors if a sonographically complex lesion was present. Based on our experience, surgical management of ovarian cysts should be reserved to complex masses. Simple cysts can be monitored safely by close US follow-up; surgery is indicated if the cyst fails to regress after several months or becomes symptomatic.

Transumbilical management for neonatal ovarian cysts

“…Enríquez et al [15] compared the result of conservative vs surgical treatment of complex neonatal ovarian cysts and recommended conservative management with clinical and sonographic monitoring for complex neonatal ovarian cyst. However, twisted, infarcted cyst may cause inflammatory adhesion to the bowel loops [16,17] and lead to intestinal obstruction and/or rupture with peritonitis [10]. Another point is that ultrasound cannot precisely differentiate a hemorrhagic cyst from cystic torsion [17] or other causes of abdominal cysts.…”

Is the stripping technique a tissue-sparing procedure in large simple ovarian cysts in children?

“…Aspiration of large ovarian cysts during the neonatal period has been reported to be successful, without recurrence of the cyst [2,17].…”

“…If surgery is chosen, the laparoscopic approach is nowadays generally favored even in infants [17]. Whether a laparoscopic technique is chosen, simple cysts should undergo fenestration [17].…”

Large ovarian cyst in children: differential diagnostic problem – case report

“…Prvi opis potiče iz 1889. godine kada je Doran opisao ovarijalnu cistu kod sedmomjesečnog fetusa koji je umro na rođenju. 1908. godine opisana je cista jajnika kod djeteta koja je operativno uspješno odstranjena [1][2][3].…”