Management of Neonatal Ovarian Cysts: A Case Report of 18 Patients

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  • 当科における新生児卵巣囊嚢腫18例の検討
  • トウ カ ニ オケル シンセイジ ランソウノウノウ シュ 18レイ ノ ケントウ

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Abstract

<p>Purpose: The assessment of risk factors for the necrosis of neonatal ovarian cysts is important to preserve fertility because ovarian cysts are often necrotic at the time of surgery. We assessed retrospectively the imaging findings of patients with congenital ovarian cysts and established the risk factors for necrosis and an appropriate treatment strategy for this disease.</p><p>Methods: Clinical data were obtained from the case records of 18 patients who were prenatally diagnosed as having ovarian cysts between 2003 and 2016. The gestational age of detection, shift in location, intracystic finding, and maximum diameter of ovarian cysts were observed sequentially. Then, we investigated the symptoms, age at operation, cause of torsion/autoamputation, operative procedure, and histopathological findings.</p><p>Results: Simple cysts spontaneously regressed in seven patients. Surgical treatment was performed using a laparoscopic procedure in 11 patients with complex and simple cysts, which were >4 cm in diameter or cystic lesions with undetermined diagnosis. Simple cysts, torsion, autoamputation, and necrosis were intraoperatively observed in three, three, two, and three patients, respectively. The prenatal or postnatal examinations revealed the cysts that shifted from side to side in all eight patients with necrotic changes in the ovaries. The diameters of the complex cysts at birth were larger than those of the simple cysts.</p><p>Conclusions: Results indicated that the imaging findings of mobility beyond the midline and large diameter, in addition to the findings of complex cysts, would be the predictive factors for necrosis in neonatal ovarian cysts. Prompt surgery should be carried out for the preservation of fertility.</p>

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