Conservative Management in Three Cases of Prenatally Recognized Splenic Cyst Using 2D, 3D, Multi-Slice and Doppler Ultrasonography

Abstract

The aetiology, differential diagnosis and management strategies of the foetal spleen affected with a cystic lesion are discussed. In the current literature, there are very few reports that relate to antenatally diagnosed splenic cyst. Our study presents 3 case reports that were first suspected due to anisoechogenic structures detected during routine ultrasonographic examination at the 27th, 31st and 34th weeks of gestation. All 3 cases were further characterized by the lack of pathological power Doppler findings inside and around the lesions, and were morphologically refined by prenatal 3D ultrasound imaging. All findings were reconfirmed postnatally. No complications such as cyst expansion, subcapsular bleeding or acute abdomen have developed, and all 3 cystic lesions have regressed spontaneously after birth.

Reference ranges of fetal spleen biometric parameters and volume assessed by three‐dimensional ultrasound and their applicability in spleen malformations

“…Several rotation angles (6°, 9°, 15°, and 30°) were available according to different demands . It has also been reported by both Dankovcik et al . and Cheong et al .…”

“…Few studies on US diagnosis of fetal splenic abnormalities have been published . One explanation is that fetal splenic abnormalities are rare, especially during the early period of development.…”

“…Early ultrasonographic examination is 1.5 times more likely to detect complex developmental defects during fetal development rather than isolated malformations . Few studies, however, have been published on ultrasonic diagnoses of fetal splenic abnormalities . The clinical values of fetal spleen evaluation and the parameters by which to do so are not well defined.…”

Imaging and Differential Diagnosis of Suprarenal Masses in the Fetus

“…Gastric duplication cysts, often arising from the greater curvature, antrum, and pyloris of the stomach, can mimic fetal suprarenal masses 13 . Also, a splenic cyst may present as a left suprarenal mass; however, it is rarely seen in utero 14 …”

Prenatal and postnatal evolution of isolated fetal splenic cysts

“…Splenic cysts can be divided into two types: parasitic cysts (due to Echinococcus granulosus , found in endemic zones) and nonparasitic cysts . They have been classified on the basis of the presence or absence of an epithelial lining: primary or congenital splenic cysts have a cellular layer whereas secondary, or pseudocysts, do not . Primary splenic cysts contribute to 10% of all nonparasitic cysts of the spleen.…”