http://informahealthcare.com/jmf ISSN: 1476-7058 (print), 1476-4954 (electronic) J Matern Fetal Neonatal Med, 2014; 27(14): 1500–1501 ! 2014 Informa UK Ltd. DOI: 10.3109/14767058.2013.864632
LETTER TO EDITOR
Response to article – Outcome of sonographically suspected fetal ovarian cysts (Published in issue 26[17]) Fatma Uysal1, Mustafa Re¸sorlu1, Gu¨rhan Adam1, and Ahmet Uysal2 1
Department of Radiology and 2Department of Obstetrics and Gynecology, C¸anakkale Onsekiz Mart University, Canakkale, Turkey
Recently we read a very interesting study in the Journal of Maternal Fetal & Neonatal Medicine which was entitled ‘‘Outcome of sonographically suspected fetal ovarian cysts [1]’’. In the paper, the authors reviewed prenatal sonographic data and postnatal medical records of 29 fetuses that were suspected to have ovarian cysts. They confirmed initial antenatal diagnosis of ovarian cyst in 20 cases at postnatal period. Diagnosis of remaining one of the cases revealed mesenteric cyst postnatally. In this regard, we want to present a very rare case of fetal abdominal cystic masses using sonographic imaging which was confirmed by pathological fetal mesenteric cyst. A 25-year-old primigravida patient, in the 21st week of pregnancy according to last menstrual period, presented to our clinic for routine ultrasonography. The patient’s obstetric history contained no drug abuse or disease. The family history of the patient contained no anomalous birth history or consanguineous. Ultrasonographic investigation revealed a female fetus with biometric readings appropriate to 21 weeks gestation. In the right lateral abdominal region, extending from bladder to liver, a 19 25 mm, well-defined, thinwalled, pure anechoic cystic structure with no septa or solid component was observed (Figure 1). Color Doppler examination showed no blood flow within the lesion, ruling out an aneurismatic vascular structure. The described lesion was observed to be separate from the bladder and both kidneys, so a urinary system anomaly was excluded (Figure 1). The gallbladder was imaged with normal location and size, separate from the lesion, and bile duct cystic anomalies were ruled out (Figure 2). As dilatation was not observed in the intestinal loops and a duplication cyst diagnosis was abandoned. Fetal biometric measurements and amniotic fluid levels were normal. The location of the cystic mass far from the pelvis reduced the probability of an ovarian cystic structure, but did not definitively rule out this possibility. Apart from the abdominal cystic mass, there was no anomaly observed in the gastrointestinal system, skeletal system or any other system in the fetus. The appearance, location and Address for correspondence: Ahmet Uysal, Assist. Prof, Department of Obstetrics and Gynecology, C ¸ anakkale Onsekiz Mart University, Canakkale, Turkey, Tel: +90 0505 287 42 31. E-mail: drahmetuysal@ hotmail.com
Figure 1. Coronal cross-section of the fetus at abdominal and thorax level showing cystic lesion in the right half of the abdomen separate from the bladder.
Figure 2. Sagittal cross-section of the abdomen with cystic lesion separate from the gallbladder.
Letter to Editor
DOI: 10.3109/14767058.2013.864632
structure indicated a pre-diagnosis of fetal mesenteric cyst. With the knowledge and permission of the family, the mass was observed until term without the development of any complications. In the 39th week of pregnancy, while the cystic mass was 36 44 mm, the fetus was born by elective cesarean. On the 5th day after the birth, laparotomy was performed at an outside center and the pathologic diagnosis was confirmed as mesenteric cyst. Three days after the operation the newborn was discharged without problems.
1501
Declaration of interest We declare that we have no conflict of interest
Reference 1. Turgal M, Ozyuncu O, Yazicioglu A. Outcome of sonographically suspected fetal ovarian cysts. J Matern Fetal Neonatal Med 2013; 26:1728–32.
Copyright of Journal of Maternal-Fetal & Neonatal Medicine is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
LETTER TO EDITOR
Response to article – Outcome of sonographically suspected fetal ovarian cysts (Published in issue 26[17]) Fatma Uysal1, Mustafa Re¸sorlu1, Gu¨rhan Adam1, and Ahmet Uysal2 1
Department of Radiology and 2Department of Obstetrics and Gynecology, C¸anakkale Onsekiz Mart University, Canakkale, Turkey
Recently we read a very interesting study in the Journal of Maternal Fetal & Neonatal Medicine which was entitled ‘‘Outcome of sonographically suspected fetal ovarian cysts [1]’’. In the paper, the authors reviewed prenatal sonographic data and postnatal medical records of 29 fetuses that were suspected to have ovarian cysts. They confirmed initial antenatal diagnosis of ovarian cyst in 20 cases at postnatal period. Diagnosis of remaining one of the cases revealed mesenteric cyst postnatally. In this regard, we want to present a very rare case of fetal abdominal cystic masses using sonographic imaging which was confirmed by pathological fetal mesenteric cyst. A 25-year-old primigravida patient, in the 21st week of pregnancy according to last menstrual period, presented to our clinic for routine ultrasonography. The patient’s obstetric history contained no drug abuse or disease. The family history of the patient contained no anomalous birth history or consanguineous. Ultrasonographic investigation revealed a female fetus with biometric readings appropriate to 21 weeks gestation. In the right lateral abdominal region, extending from bladder to liver, a 19 25 mm, well-defined, thinwalled, pure anechoic cystic structure with no septa or solid component was observed (Figure 1). Color Doppler examination showed no blood flow within the lesion, ruling out an aneurismatic vascular structure. The described lesion was observed to be separate from the bladder and both kidneys, so a urinary system anomaly was excluded (Figure 1). The gallbladder was imaged with normal location and size, separate from the lesion, and bile duct cystic anomalies were ruled out (Figure 2). As dilatation was not observed in the intestinal loops and a duplication cyst diagnosis was abandoned. Fetal biometric measurements and amniotic fluid levels were normal. The location of the cystic mass far from the pelvis reduced the probability of an ovarian cystic structure, but did not definitively rule out this possibility. Apart from the abdominal cystic mass, there was no anomaly observed in the gastrointestinal system, skeletal system or any other system in the fetus. The appearance, location and Address for correspondence: Ahmet Uysal, Assist. Prof, Department of Obstetrics and Gynecology, C ¸ anakkale Onsekiz Mart University, Canakkale, Turkey, Tel: +90 0505 287 42 31. E-mail: drahmetuysal@ hotmail.com
Figure 1. Coronal cross-section of the fetus at abdominal and thorax level showing cystic lesion in the right half of the abdomen separate from the bladder.
Figure 2. Sagittal cross-section of the abdomen with cystic lesion separate from the gallbladder.
Letter to Editor
DOI: 10.3109/14767058.2013.864632
structure indicated a pre-diagnosis of fetal mesenteric cyst. With the knowledge and permission of the family, the mass was observed until term without the development of any complications. In the 39th week of pregnancy, while the cystic mass was 36 44 mm, the fetus was born by elective cesarean. On the 5th day after the birth, laparotomy was performed at an outside center and the pathologic diagnosis was confirmed as mesenteric cyst. Three days after the operation the newborn was discharged without problems.
1501
Declaration of interest We declare that we have no conflict of interest
Reference 1. Turgal M, Ozyuncu O, Yazicioglu A. Outcome of sonographically suspected fetal ovarian cysts. J Matern Fetal Neonatal Med 2013; 26:1728–32.
Copyright of Journal of Maternal-Fetal & Neonatal Medicine is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
