Case 246: MR Imaging of a Complex Cystic Mass in a Newborn Girl

Abstract

History A 6-day-old female neonate presented to the outpatient pediatric surgery clinic for evaluation of a possible prenatal abdominal mass. The neonate was delivered at term via cesarean section due to macrosomia, with a reported birth weight of 11 lb 8.7 oz (5.23 kg). The patient's postnatal course was remarkable for resolving neonatal hyperbilirubinemia. A physical examination was remarkable for a palpable mass in the abdomen. Maternal risk factors included class II obesity, type 2 diabetes, and metabolic syndrome. Prenatal images obtained at an outside institution were not available at this time. Ultrasonography (US) of the abdomen and pelvis was performed 6 days after birth. Follow-up US at 29 days of life revealed no substantial change in the appearance of the findings. This patient remained asymptomatic, and gadolinium-enhanced (Magnevist; Bayer Pharma, Berlin, Germany) magnetic resonance (MR) imaging of the abdomen and pelvis was performed at 84 days of life. The mass was excised surgically at 89 days of life, and the patient had an uncomplicated postoperative course.

Yenidoğan döneminde geçici endokrin sorunlar

“…The cyst may be simple or complex. A finding that suggests that the cyst originates from the ovary is the presence of small daughter cysts on the cyst wall or in the region where the cyst is found (36). If the cyst’s pedicle is twisted, an appearance of a snail shell emerges.…”

“…In the differential diagnosis, enteric duplication cyst, cystic lymphangioma, meconium pseudocyst, hydrometrocolpos, ovarian tumors (cystadenoma, cystic teratoma, granulosa cell tumor), and urachal cyst should be considered. Ovarian tumors are generally solid, tend to enlarge, and are associated with ascites (36).…”

“…If its diameter is 5–6 cm, there is a risk for torsion, intracystic hemorrhage, and intestinal and urinary stenosis. If the cyst’s diameter is 3–5 cm in the prenatal period, there is a risk for rupture, peritonitis, chorioamnionitis, and fetal injury, though aspiration is recommended (36). If distension and pressure effects are present, which could hinder vaginal delivery, aspiration may be performed (34).…”