Abstract
This paper describes the perinatal and postnatal outcome of a case considered to have a fetal ovarian cyst. At 29 weeks of gestation, routine ultrasound examination showed an anechoic cyst 15x16mm in diameter located in the abdomen at the left superolateral side of the bladder. The normal fetal anatomy of other abdominal organs and gender suggested an ovarian cyst as the most likely diagnosis and mesenteric or duplication cyst as differential diagnosis. Ultrasonographic follow-ups documented an increase in size to 40x22mm by 36 weeks of gestation. At postnatal 4 months, ultrasonographic scan showed a left-sided complex ovarian cyst 40x39mm in diameter containing fluid-debris levels and suggesting haemorrhage and/or torsion. At 4.5 months of age laparoscopic exploration demonstrated a normal right ovary and fallopian tube and a left ovary that had undergone torsion and remained a cystic structure. A laparoscopic left salpingo-oophorectomy was performed. Pathological examination demonstrated a microscopic amount of intact ovarian tissue. Fibrosis, dystrophic calcification and multinucleated cells were observed in the cyst wall, suggesting intrauterin torsion of the ovary. Torsion is one of the most serious complications that occur more frequently during fetal life than postnatally and may lead to loss of the gonad
References
- Crombleholme TM, Craigo SD, Garmel S, Dalton ME. Fetal ovarian cyst decompression to prevent torsion. J Pediatr Surg 1997;32:1447-9.
- Bryant AE, Laufer MR. Fetal ovarian cysts: incidence, diagnosis and management. J Reprod Med 2004;49:329-37.
- deSA DJ. Follicular ovarian cysts in stillbirths and neonates. Arch Dis Child 1975;50:45-50.
- Heling KS, Chaoui R, Kircmair F, et al. Fetal ovarian cysts: Prenatal diagnosis, management and postnatal outcome. Ultrasound Obstet Gynecol 2002;20:47-50.
- Meizner I, Levy A, Katz M, Maresh AJ, Glezerman M. Fetal ovarian cysts: Prenatal ultrasonographic detection and postnatal evaluation and treatment. Am J Obstet Gynecol 1999;164:874-8.
- Rizzo N, Gabrielle S, Perolo A et al. Prenatal diagnosis and management of fetal ovarian cysts. Prenatal Diagn 1989;9:97-104.
- Brandt ML, Helmrath MA. Ovarian cysts in infants and children. Semin Pediatr Surg 2005;14:78-85.
- Nyberg D, Mahoney B, Pretorius D, eds. Diagnostic Ultrasound in Fetal Anomalies. Year Book Medical, Chicago, 1990.
- Twining P, McHugo J, Pilling D. Textbook of Fetal Abnormalities. Churchill Livingstone, Edinburg, 2000.
- Foley PT, Ford WD, McEwing r, Furness M: Is conservative management of prenatal and neonatal ovarian cysts justifiable? Fetal Diagn Ther 2005;20:454-8.
- Suita S, Handa N, Nakano H. Antenatally detectecd ovarian cysts-a therapeutic dilemma. Early Human Dev 1992;29:363-7.
- Brandt ML, Luks FI, Filiatrault D, Garel L, Desjardins JG, Youssef S. Surgical indications in antenatally diagnosesd ovarian cysts. J Pediatr Surg 1991;26:276-82.
- Bagolan P, Rivosecchi M, Giorlandino C, Bilancioni E, Nahom A, Zaccara A, Trucchi A, Ferro F. Prenatal diagnosis and clinical outcome of ovarian cysts. J Pediatr Surg 1992;27:879-81.
- Sakala EP, Leon ZA, Rouse GA. Management of antenatally diagnosed fetal ovarian cysts. Obstet Gynecol Surv 1991;46:407-14.
- Muller-Leisse C, Bick U, Paulussen K et al. Ovarian cysts in the fetus and neonate-changes in sonographic pattern in the follow up and their management. Pediatr Radiol 1992;22:395-400.
- Zamora M, Gonzalez N. Spontaneous resolution of a sonographically complicated fetal ovarian cyst. J Ultrasound Med 1992;11:567-9.
- Crombleholme T, Craigo S, Garmel S, D’Alton ME. Fetal cyst decompression to prevent torsion. J Ped Surg 1997;32:1447-9.
Abstract
Bu yazı, fetal over kisti olarak kabul edilen bir olgunun perinatal ve postnatal sonucunu tanımlamaktadır. 29. gebelik haftasında, rutin ultrasonografik incelemede abdomende mesanenin sol superolateral tarafında çapı 15x16 mm olan anekoik kist görüldü. Diğer fetal abdominal organların normal anatomisi ve cinsiyet en olasılıklı tanı olarak ovaryen kisti, ayırıcı tanıda ise mezenterik veya duplikasyon kistini düşündürdü. Ultrasonografik takipler kist çapındaki büyümenin 36. gebelik haftasına kadar 40x22 mm olduğunu gösterdi. Doğum sonrası 4. ayda, ultrasonografik incelemede, çapı 40x39 mm olan sol taraf yerleşimli, sıvı-debris içeren kompleks over kisti görüldü ve bu bulgular hemoraji ve/veya torsiyonu düşündürdü. Bebeğe 4.5 aylıkken yapılan laparoskopik incelemede, normal sağ over ve fallop tübü ve torsiyone olmuş kistik yapıdaki sol over görülerek sol salpingo-ooferektomi yapıldı. Patoloji raporunda mikroskopik düzeyde sağlam over dokusunun olduğu belirtildi. Kist duvarındaki fibrozis, distrofik kalsifikasyon ve çok çekirdekli hücreler over torsiyonunun intrauterin olduğunu düşündürdü. Torsiyon fetal hayatta postnatal döneme göre daha sıklıkla olan en önemli komplikasyonlardan birisidir ve gonadın kaybına neden olabilir
References
- Crombleholme TM, Craigo SD, Garmel S, Dalton ME. Fetal ovarian cyst decompression to prevent torsion. J Pediatr Surg 1997;32:1447-9.
- Bryant AE, Laufer MR. Fetal ovarian cysts: incidence, diagnosis and management. J Reprod Med 2004;49:329-37.
- deSA DJ. Follicular ovarian cysts in stillbirths and neonates. Arch Dis Child 1975;50:45-50.
- Heling KS, Chaoui R, Kircmair F, et al. Fetal ovarian cysts: Prenatal diagnosis, management and postnatal outcome. Ultrasound Obstet Gynecol 2002;20:47-50.
- Meizner I, Levy A, Katz M, Maresh AJ, Glezerman M. Fetal ovarian cysts: Prenatal ultrasonographic detection and postnatal evaluation and treatment. Am J Obstet Gynecol 1999;164:874-8.
- Rizzo N, Gabrielle S, Perolo A et al. Prenatal diagnosis and management of fetal ovarian cysts. Prenatal Diagn 1989;9:97-104.
- Brandt ML, Helmrath MA. Ovarian cysts in infants and children. Semin Pediatr Surg 2005;14:78-85.
- Nyberg D, Mahoney B, Pretorius D, eds. Diagnostic Ultrasound in Fetal Anomalies. Year Book Medical, Chicago, 1990.
- Twining P, McHugo J, Pilling D. Textbook of Fetal Abnormalities. Churchill Livingstone, Edinburg, 2000.
- Foley PT, Ford WD, McEwing r, Furness M: Is conservative management of prenatal and neonatal ovarian cysts justifiable? Fetal Diagn Ther 2005;20:454-8.
- Suita S, Handa N, Nakano H. Antenatally detectecd ovarian cysts-a therapeutic dilemma. Early Human Dev 1992;29:363-7.
- Brandt ML, Luks FI, Filiatrault D, Garel L, Desjardins JG, Youssef S. Surgical indications in antenatally diagnosesd ovarian cysts. J Pediatr Surg 1991;26:276-82.
- Bagolan P, Rivosecchi M, Giorlandino C, Bilancioni E, Nahom A, Zaccara A, Trucchi A, Ferro F. Prenatal diagnosis and clinical outcome of ovarian cysts. J Pediatr Surg 1992;27:879-81.
- Sakala EP, Leon ZA, Rouse GA. Management of antenatally diagnosed fetal ovarian cysts. Obstet Gynecol Surv 1991;46:407-14.
- Muller-Leisse C, Bick U, Paulussen K et al. Ovarian cysts in the fetus and neonate-changes in sonographic pattern in the follow up and their management. Pediatr Radiol 1992;22:395-400.
- Zamora M, Gonzalez N. Spontaneous resolution of a sonographically complicated fetal ovarian cyst. J Ultrasound Med 1992;11:567-9.
- Crombleholme T, Craigo S, Garmel S, D’Alton ME. Fetal cyst decompression to prevent torsion. J Ped Surg 1997;32:1447-9.
Details
| Primary Language | English |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | March 1, 2017 |
| Published in Issue | Year 2017Issue: 1 |