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Neonatal ovarian cysts: sonographic-pathologic correlation.

A R Nussbaum1, R C Sanders, D S Hartman

  • 1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD 21205.

Radiology
|September 1, 1988
PubMed
Summary
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Neonatal ovarian cysts often appear complicated on ultrasounds, especially when twisted or hemorrhagic. Most follicular cysts require surgery, though some resolve spontaneously.

Area of Science:

  • Pediatric Radiology
  • Neonatal Surgery
  • Gynecologic Pathology

Background:

  • Neonatal ovarian cysts are common but their sonographic features and natural history require further elucidation.
  • Distinguishing between uncomplicated and complicated neonatal ovarian cysts is crucial for management.

Purpose of the Study:

  • To determine the sonographic features and natural history of neonatal ovarian cysts.
  • To correlate sonographic findings with clinical, surgical, and pathologic outcomes.

Main Methods:

  • Retrospective review of prenatal and postnatal sonograms in 17 infants with ovarian cysts.
  • Analysis of clinical, surgical, and pathologic findings.
  • Correlation of sonographic characteristics with cyst complications and outcomes.

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Main Results:

  • Uncomplicated cysts were anechoic with imperceptible walls.
  • Complicated cysts (twisted/hemorrhagic) showed varied sonographic appearances including fluid-debris levels, retracting clots, septations, or solid components, often with a thin, echogenic wall.
  • Cyst torsion frequently occurred in utero, detectable prenatally.
  • Most infants with uncomplicated cysts were asymptomatic; four with complicated cysts were symptomatic.
  • Surgical intervention was common, with spontaneous resolution in only one case.

Conclusions:

  • Sonography can effectively characterize neonatal ovarian cysts, differentiating uncomplicated from complicated types.
  • Complicated cysts, particularly those with torsion or hemorrhage, often necessitate surgical management.
  • Follicular origin is the predominant pathology for neonatal ovarian cysts.