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Neonatal Ovarian Cysts

  • Gloria Pelizzo
Chapter

Abstract

Ovarian cysts are the most common intra-abdominal masses found in female fetuses and neonates.

To date, the prenatal detection rate for neonatal ovarian cysts (NOC) is more than 30%. Although spontaneous regression occurs in more than half of prenatally detected NOC cases, complications of fetal ovarian cysts include compression of other viscera, cyst rupture, hemorrhage, and, most frequently, ovarian torsion with consequent loss of the ovary.

Management includes both watchful expectancy in utero and postnatal or antenatal aspiration of large simple cysts, to prevent torsion and ovarian loss. Prenatal monitoring of recurrent complex cysts and postnatal follow-up in the case of simple cyst recurrence are mandatory. Surgical intervention should be considered only in symptomatic or complex cases.

When a surgical intervention is pursued, an ovary preserving approach should be emphasized for all types of cysts, regardless of size, complexity, or presence of antenatal or postnatal torsion.

Keywords

Ovarian Cyst Fetal Neonatal Surgery 

Notes

Acknowledgments

The author thanks Dr. Calcaterra V. of the Pediatrics and Adolescentology Unit, Department of Internal Medicine and Therapeutics, University of Pavia, Italy, and Dr. Re A. of the Pediatric Radiology, Children’s Hospital, ARNAS Civico-Di Cristina-Benfratelli, Palermo, Italy.

References

  1. 1.
    Doran AH. Large ovarian tumors in 7 months old child. London: Trans Path Soc; 1889.Google Scholar
  2. 2.
    Carlson DH, Griscom TN. Ovarian cysts in the newborn. Am J Roentgenol. 1972;116:664–72.CrossRefGoogle Scholar
  3. 3.
    Monnery-Noché ME, Auber F, Jouannic JM, Bénifla JL, Carbonne B, Dommergues M, Lenoir M, Lepointe HD, Larroquet M, Grapin C, Audry G, Hélardot PG. Fetal and neonatal ovarian cysts: is surgery indicated? Prenat Diagn. 2008;28:15–20.CrossRefGoogle Scholar
  4. 4.
    Galinier P, Carfagna L, Juricic M, Lemasson F, Moscovici J, Guitard J, Baunin C, Menendez M, Cartault A, Pienkowski C, Kessler S, Sarramon MF, Vaysse P. Fetal ovarian cysts management and ovarian prognosis: a report of 82 cases. J Pediatr Surg. 2008;43:2004–9.CrossRefGoogle Scholar
  5. 5.
    Zampieri N, Borruto F, Zamboni C, Camoglio FS. Foetal and neonatal ovarian cysts: a 5-year experience. Arch Gynecol Obstet. 2008;277:303–6.CrossRefGoogle Scholar
  6. 6.
    Shimada T, Miura K, Gotoh H, Nakayama D, Masuzaki H. Management of prenatal ovarian cysts. Early Hum Dev. 2008;84:417–20.CrossRefGoogle Scholar
  7. 7.
    Erol O, Erol MB, Isenlik BS, Ozkiraz S, Karaca M. Prenatal diagnosis of fetal ovarian cyst: case report and review of the literature. J Turk Ger Gynecol Assoc. 2013;14(2):119–22.CrossRefGoogle Scholar
  8. 8.
    Enríquez G, Durán C, Torán N, Piqueras J, Gratacós E, Aso C, et al. Conservative versus surgical treatment for complex neonatal ovarian cysts: outcomes study. AJR Am J Roentgenol. 2005;185:501–8.CrossRefGoogle Scholar
  9. 9.
    Arisaka O, Kanazawa S, Ohyama M, Nitta A, Suzumura H, Kuribayashi T. Elevated circulating estradiol level in neonatal ovarian cyst. Arch Pediatr Adolesc Med. 1999;153(11):1202–3.CrossRefGoogle Scholar
  10. 10.
    Hasiakos D, Papakonstantinou K, Bacanu AM, Argeitis J, Botsis D, Vitoratos N. Clinical experience of five fetal ovarian cysts: diagnosis and follow-up. Arch Gynecol Obstet. 2008;277:575–8.CrossRefGoogle Scholar
  11. 11.
    Jafri SZ, Bree RL, Silver TM, Ouimette M. Fetal ovarian cysts: sonographic detection and association with hypothyroidism. Radiology. 1984;150:809–12.CrossRefGoogle Scholar
  12. 12.
    Gaspari L, Paris F, Nicolino M, Hameury F, Bonnaure H, Pienkowski C, et al. Fetal ovarian cysts: an early manifestation of McCune-Albright syndrome? Prenat Diagn. 2012;32:859–63.PubMedGoogle Scholar
  13. 13.
    Chen CE, Di TW, Zhu RH, Zhang LL, Wang Q, Qian Y, Sun YY. Preterm ovarian hyperstimulation syndrome: a case report and literature review. Zhonghua Er Ke Za Zhi. 2016;54(4):283–6.PubMedGoogle Scholar
  14. 14.
    Kessler A, Nagar H, Graif M, Ben-Sira L, Miller E, Fisher D, Hadas-Halperin I. Percutaneous drainage as the treatment of choice for neonatal ovarian cysts. Pediatr Radiol. 2006;36:954–8.CrossRefGoogle Scholar
  15. 15.
    Vogtländer MF, Rijntjes-Jacobs EGJ, van den Hoonaard TL, Versteegh FGA. Neonatal ovarian cysts. Acta Paediatr. 2003;92:498–501.CrossRefGoogle Scholar
  16. 16.
    Prasad S, Chui CH. Laparoscopic-assisted transumbilical ovarian cystectomy in a neonate. JSLS. 2007;11:138–41.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Bascietto F, Liberati M, Marrone L, Khalil A, Pagani G, Gustapane S, Leombroni M, Buca D, Flacco ME, Rizzo G, Acharya G, Manzoli L, D’Antonio F. Outcome of fetal ovarian cysts diagnosed on prenatal ultrasound examination: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2017;50(1):20–31.CrossRefGoogle Scholar
  18. 18.
    Dolgin SE. Ovarian masses in the newborn. Semin Pediatr Surg. 2000;9(3):121–7.CrossRefGoogle Scholar
  19. 19.
    Papic JC, Billmire DF, Rescorla FJ, Finnell SM, Leys CM. Management of neonatal ovarian cysts and its effect on ovarian preservation. J Pediatr Surg. 2014;49(6):990–3.CrossRefGoogle Scholar
  20. 20.
    Nussbaum AR, Sanders RC, Benator RM, Haller JAJ, Dudgeon DL. Spontaneous resolution of neonatal ovarian cysts. AJR Am J Roentgenol. 1987;148:175–6.CrossRefGoogle Scholar
  21. 21.
    Kuroiva M, Hatakeyama S, Suzuki N, Murai H, Toki F, Tsuchida Y. Neonatal ovarian cysts: management with reference to magnetic resonance imaging. Asian J Surg. 2004;27:43–8.CrossRefGoogle Scholar
  22. 22.
    Trinh TW, Kennedy AM. Fetal ovarian cysts: review of imaging spectrum, differential diagnosis, management, and outcome. Radiographics. 2015;35(2):621–35.CrossRefGoogle Scholar
  23. 23.
    Akın MA, Akın L, Özbek S, Tireli G, Kavuncuoğlu S, Sander S, Akçakuş M, Güneş T, Öztürk MA, Kurtoğlu S. Fetal-neonatal ovarian cysts--their monitoring and management: retrospective evaluation of 20 cases and review of the literature. J Clin Res Pediatr Endocrinol. 2010;2(1):28–33.CrossRefGoogle Scholar
  24. 24.
    Kwak DW, Sohn YS, Kim SK, Kim IK, Park YW, Kim YH. Clinical experiences of fetal ovarian cyst: diagnosis and consequence. J Korean Med Sci. 2006;21:690–4.CrossRefGoogle Scholar
  25. 25.
    Dobremez E, Moro A, Bondonny J-M, Vergnes P. Laparoscopic treatment of ovarian cyst in the newborn, A series of nine cases. Surg Endosc. 2003;17:328–32.CrossRefGoogle Scholar
  26. 26.
    Arena F, Romeo C, Castagnetti M, Scalfari GF, Cimador M, Impellizzeri P, Villari D, Zimbaro F, DeGrazia E. Is the stripping technique a tissue-sparing procedure in large simple ovarian cysts in children? J Pediatr Surg. 2008;43:1353–7.CrossRefGoogle Scholar
  27. 27.
    Lin JY, Lee ZF, Chang YT. Transumbilical management for neonatal ovarian cysts. J Pediatr Surg. 2007;42:2136–9.CrossRefGoogle Scholar
  28. 28.
    Kim HS, Yoo SY, Cha MJ, Kim JH, Jeon TY, Kim WK. Diagnosis of neonatal ovarian torsion: emphasis on prenatal and postnatal sonographic findings. J Clin Ultrasound. 2016;44(5):290–7.CrossRefGoogle Scholar
  29. 29.
    Turgal M, Ozyuncu O, Yazicioglu A. Outcome of sonographically suspected fetal ovarian cysts. J Matern Fetal Neonatal Med. 2013;26(17):1728–32.CrossRefGoogle Scholar
  30. 30.
    De Backer A, Madern GC, Oosterhuis JW, et al. Ovarian germ cell tumors in children: a clinical study of 66 patients. Pediatr Blood Cancer. 2006;46:459–64.CrossRefGoogle Scholar
  31. 31.
    Marinković S, Jokić R, Bukarica S, Mikić AN, Vucković N, Antić J. Surgical treatment of neonatal ovarian cysts. Med Pregl. 2011;64(7–8):408–12.CrossRefGoogle Scholar
  32. 32.
    Aamir M, Punia H, Dalal P, Sharma D. Conservative management of a large neonatal ovarian cyst: a case report. J Clin Diagn Res. 2015;9(4):SD04–5.PubMedPubMedCentralGoogle Scholar
  33. 33.
    Cho MJ, Kim DY, Kim SC. Ovarian cyst aspiration in the neonate: minimally invasive surgery. J Pediatr Adolesc Gynecol. 2015;28(5):348–53.CrossRefGoogle Scholar
  34. 34.
    Cesca E, Midrio P, Boscolo-Berto R, Snijders D, Salvador L, D’Antona D, Zanon GF, Gamba P. Conservative treatment for complex neonatal ovarian cysts: a long-term follow-up analysis. J Pediatr Surg. 2013;48(3):510–5.CrossRefGoogle Scholar
  35. 35.
    Ikeda K, Suita S, Nakano H. Management of ovarian cyst detected antenatally. J Pediatr Surg. 1988;23(5):432–5.CrossRefGoogle Scholar
  36. 36.
    Nakamura M, Ishii K, Murata M, Sasahara J, Mitsuda N. Postnatal outcome in cases of prenatally diagnosed fetal ovarian cysts under conservative prenatal management. Fetal Diagn Ther. 2015;37(2):129–34.CrossRefGoogle Scholar
  37. 37.
    Dera-Szymanowska A, Malinger A, Madejczyk M, Szymanowski K, Bręborowicz GH, Opala T. Recurrent fetal complex ovarian cysts with rupture followed by simple cyst in the neonatal period with no adverse sequelae. J Matern Fetal Neonatal Med. 2016;29:328–30.CrossRefGoogle Scholar
  38. 38.
    Panteli C, Minocha A, Kulkarni MS, Tsang T. The role of laparoscopy in the management of adnexal lesions in children. Surg Laparosc Endosc Percutan Tech. 2009;19:514–7.CrossRefGoogle Scholar
  39. 39.
    Pujar VC, Joshi SS, Pujar YV, Dhumale HA. Role of laparoscopy in the management of neonatal ovarian cysts. J Neonatal Surg. 2014;3:16.PubMedPubMedCentralGoogle Scholar
  40. 40.
    Heling KS, Chaoi R, Kirchmair F, Stadie S, Bollmann R. Fetal ovarian cysts: prenatal diagnosis, management and postnatal outcome. Ultrasound Obstet Gynecol. 2002;20:47–52.CrossRefGoogle Scholar
  41. 41.
    Aslam A, Wong C, Haworth JM. Autoamputation of ovarian cyst in an infant. J Pediatr Surg. 1995;30:1609–10.CrossRefGoogle Scholar
  42. 42.
    Esposito C, Garipoli V, Di Matteo G, De Pasquale M. Laparoscopic management of ovarian cysts in newborns. Surg Endosc. 1998;12:1152–4.CrossRefGoogle Scholar
  43. 43.
    Nakib G, Calcaterra V, Scorletti F, Romano P, Goruppi I, Mencherini S, Avolio L, Pelizzo G. Robotic assisted surgery in pediatric gynecology: promising innovation in mini invasive surgical procedures. J Pediatr Adolesc Gynecol. 2013;26:e5–7.CrossRefGoogle Scholar
  44. 44.
    Schenkman L, Weiner TM, Phillips JD. Evolution of the surgical management of neonatal ovarian cysts: laparoscopic-assisted transumbilical extracorporeal ovarian cystectomy (LATEC). J Laparoendosc Adv Surg Tech A. 2008;18:635–40.CrossRefGoogle Scholar
  45. 45.
    Antao B, Tan J, Quinn F. Laparoscopic excision of large intra-abdominal cysts in children: needle hitch technique. Case Rep Med. 2015;2015:937191.CrossRefGoogle Scholar
  46. 46.
    Stitely ML. Laparoscopic removal of a large ovarian mass utilizing planned trocar puncture. JSLS. 2012;16:148–50.CrossRefGoogle Scholar
  47. 47.
    Edwards AG, Lawrence A, Tsaltas J. Ovarian dermoid cyst leakage–a cautionary tale. Aust N Z J Obstet Gynaecol. 1998;38:332–3.CrossRefGoogle Scholar
  48. 48.
    Kondo W, Bourdel N, Cotte B, et al. Does prevention of intraperitoneal spillage when removing a dermoid cyst prevent granulomatous peritonitis? BJOG. 2010;117(8):1027–30.CrossRefGoogle Scholar
  49. 49.
    Manjiri S, Padmalatha SK, Shetty J. Management of complex cvarian cysts in newborns - our experience. J Neonatal Surg. 2017;6:3.PubMedPubMedCentralGoogle Scholar
  50. 50.
    Kozlov Y, Kovalkov K, Nowogilov V. 3D Laparoscopy in neonates and infants. J Laparoendosc Adv Surg Tech A. 2016;26(12):1021–7.CrossRefGoogle Scholar
  51. 51.
    Casey J, Yunker A, Anderson T. Gynecologic surgery in the pediatric and adolescent populations: review of perioperative and operative considerations. J Minim Invasive Gynecol. 2016;23:1033–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Gloria Pelizzo
    • 1
  1. 1.Pediatric Surgery UnitChildren’s Hospital, ARNAS Civico-Di Cristina-BenfratelliPalermoItaly

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