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Poster Display - 12
Neonatal ovarian cysts: Is surgical management the way to go? A 10 year single center review
Domingas Atouguia, Carolina Soares-Aquino, Leonor Carmo, Miguel Campos, Mariana Borges-Dias
Centro Hospitalar Universitário São João, Porto, Portugal
Purpose:
Ovarian cysts are the most common abdominal mass diagnosed in the female fetus. A complex appearance is suggestive of hemorrage/ovarian torsion. The management of neonatal ovarian cysts remains controversial. This study aims to review the clinical course of patients diagnosed with antenatal ovarian lesions at a single institution between 2015-2025.
Method:
Clinical files of patients diagnosed prenatally at our Institution or transferred with an ovarian cyst were reviewed. Demographic data, prenatal and postnatal imaging characteristics, operative and histopathological findings were collected.
Results:
13 patients were identified; The mean gestational age at diagnosis (12/13) was 34 weeks, with mean cyst size of 45 mm. At time of pre-natal diagnosis, 10 cysts were classified as simple and 2 as complex. Data from cyst characteristics on subsequent ultrasounds was available for 8/12 patients: 5 showed no changes, 2 had changes in size, and 1 evolved from simple to complex.
Postnatal imaging revealed an abdominal cyst with an undefined origin in 5 cases; size alteration in comparison with the prenatal ultrasound in 4 cases; alteration from simple to complex in 1 case. One presented bilateral cysts.
One patient was managed conservatively with spontaneous postnatal resolution. Twelve patients underwent surgical intervention, median age of 7 days (range 3–180 days), without perioperative complications: all were submitted to an oophorectomy, 5 with an initial exploratory laparoscopy due to diagnostic uncertainty. Histopathology showed 1 serous cystadenoma, 1 ovarian remnant, and hemorrhagic necrosis due to torsion in 9 patients.
Conclusion:
Large ovarian cyst may evolve from simple to complex, being the latter strongly suggestive of ovarian torsion. While the literature often supports a conservative approach based on the low incidence of neonatal neoplasms and complications, our series demonstrated that no complications were associated to surgery and we describe one case of serous cystadenoma, currently under surveillance.