Surgical aspects of the treatment of neonatal ovarian cysts in girls



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Abstract

Introduction. Neonatal ovarian cysts develop in case of hormonal imbalance in the mother-placenta-fetus system. Cystic transformation in the ovary may cause appendage torsion which leads to follicular necrosis and loss of ovarian reserve. Most often, torsion occurs in the utero, but in premature girls- due to the specific hormonal status - the risk of cyst growth and its torsion remains in the postnatal period. Currently, a unified approach to the surgical treatment of neonatal ovarian cysts is absent.

Material and methods. In the department of pediatric surgery for malformations in the Perinatal Center of the Amazov National Medical Research Center, 34 girls with ovarian cysts were examined during 2012-2020; 9 of them (27%) were premature. In the presented observation, we faced an ovarian cyst in the fetus of 30 week gestation.

Results. The cyst looked uncomplicated, but had the enormous size, so we discussed a possibility to perform an intrauterine puncture. However, due to severe hemolytic disease of the fetus and premature delivery, the intervention was not carried out. By the third week of life, torsion of the cystic-transformed ovary developed; necrosis and self-amputation of the right uterine appendage were revealed intraoperatively. By the age of three months, cystic transformation of the only ovary developed. Timely performed laparoscopic fenestration was organ-sparing. Further follow-up revealed preserved and normally growing single ovary what confirmed the right choice of surgical tactics.

Conclusion. Dynamic ultrasound examination of the pelvic organs is indicated to all premature girls, at least once every two weeks (in case of revealed ovarian cyst - weekly). We consider it reasonable to make the laparoscopic fenestration of uncomplicated cysts that have size of 3 cm and more. Newborn girls with ovarian cysts should be under the joint control of pediatrician and pediatric gynecologist for developing an individual follow-up plan.

About the authors

D. A. Malysheva

Almazov National Medical Research Centre

Author for correspondence.
Email: darmalysheva@gmail.com
ORCID iD: 0000-0002-0738-9640

Darya A Malysheva, MD, pediatric surgeon of pediatric surgical department, Institute of Perinatology and Pediatrics

Saint-Petersburg, 197341

SPIN-code: 3367-8610,

AuthorID: 1103017

Россия

A. A. Sukhotskaya

Almazov National Medical Research Centre

Email: fake@neicon.ru
ORCID iD: 0000-0002-8734-2227

Saint-Petersburg, 107341

SPIN-code: 6863-7436,

AuthorID: 647729

Россия

V. G. Bairov

Almazov National Medical Research Centre

Email: fake@neicon.ru
ORCID iD: 0000-0002-8446-830X

Saint-Petersburg, 107341

SPIN-code: 6025-8991,

AuthorID: 623392

Россия

I. M. Kagantsov

Almazov National Medical Research Centre

Email: fake@neicon.ru
ORCID iD: 0000-0002-3957-1615

Saint-Petersburg, 107341

SPIN-code: 7936-8722,

AuthorID: 333925

Россия

N. A. Kokhreidze

Almazov National Medical Research Centre

Email: fake@neicon.ru
ORCID iD: 0000-0002-0265-9728

Saint-Petersburg, 107341

SPIN-code: 9382-2225,

AuthorID: 648349

Россия

I. E. Zazerskaya

Almazov National Medical Research Centre

Email: fake@neicon.ru
ORCID iD: 0000-0003-4431-3917

Saint-Petersburg, 107341

SPIN-code: 5683-6741,

 AuthorID: 323994

Россия

F. A. Ovsyannikov

Almazov National Medical Research Centre

Email: fake@neicon.ru
ORCID iD: 0000-0002-3176-8958

Saint-Petersburg, 107341

SPIN-code: 2511-2772,

AuthorID: 597895

Россия

References

  1. Бачалдин С.Л., Рыжавская И.Б. Морфологическая характеристика кист в яичниках новорождённых и детей первого года жизни. Дальневосточный медицинский журнал. 2006; 2: 60-2.
  2. Tyraskis A., Bakalis S., David A.L, Eaton S., Coppi P. A systematic review and meta-analysis on fetal ovarian cysts: impact of size, appearance and prenatal aspiration. J.Prenat Diagn. 2017; 37 (10): 951-8.
  3. Спиридонов А.А. Трансумбиликальный доступ при операциях по поводу кист яичников больших размеров у новорождённых. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2016; 6 (1): 100-3.
  4. Ольхова Е. Б., Мукасеева Т.В. Ультразвуковая диагностика осложненной кисты яичника у новорождённой с энтероколитом. Радиология – практика. 2017; 63 (3): 39-53.
  5. Тихоненко И.В., Чуканов А.Н. Пренатальная ультразвуковая диагностика образований малого таза. II. Кисты яичников у плода: что действительно важно? Обзор литературы. Пренатальная диагностика. 2019; 18 (4): 304-12.
  6. Papic J.C., Billmire D.F., Rescorla F.J., Finnell S.M., Leys C.M. Management of neonatal ovarian cysts and its effect on ovarian preservation. J Pediatr Surg. 2014; 49 (6): 990-94.
  7. Cesca E., Midrio P., Boscolo-Berto R., Snijders D., Salvador L., D’Antona D., Zanon G.F., Gamba P. Conservative treatment for complex neonatal ovarian cysts: a long-term follow-up analysis. J Pediatr Surg. 2013; 48 (3): 510-5.
  8. Akın M.A., Akın L., Özbek S., Tireli G., Kavuncuoglu S., Sander S., et. al. Fetal-neonatal ovarian cysts-their monitoring and management: retrospective evaluation of 20 cases and review of the literature. J Clin Res Pediatr Endocrinol. 2010; 2 (1): 28-33.
  9. Gaudin J., Le Treguilly C., Parent P., Le Guern H., Chabaud J.J., Boog G., et. al. Neonatal ovarian cysts. Pediatr Surg Int 1988; 3: 158–64.
  10. Crombleholme T.M., Craigo S.D., Garmel S., D’Alton M.E. Fetal ovarian cyst decompression to prevent torsion. J Pediatr Surg. 1997; 32 (10): 1447-9.
  11. Марухно Н.И., Шапкин В.В., Черныш А.Н., Голиченко Т.Н., Вилисова Л.В., Ларионова М.В. Кисты яичников у новорождённых. Тихоокеанский медицинский журнал. 2005; 3: 85-8.
  12. Galinier P., Carfagna L., Juricic M., Lemasson F., Moscovici J., Guitard J., et. al. Fetal ovarian cysts management and ovarian prognosis: a report of 82 cases. J Pediatr Surg. 2008; 43 (11): 2004-9.
  13. Bagolan P., Rivosecchi M., Giorlandino C., Bilancioni E., Nahom A., Zaccara A., Trucchi A., Ferro F. Prenatal diagnosis and clinical outcome of ovarian cysts. J Pediatr Surg. 1992; 27 (7): 879-81.
  14. Bagolan P., Giorlandino C., Nahom A., Bilancioni E., Trucchi A., Gatti C., et. al. The management of fetal ovarian cysts. J Pediatr Surg. 2002; 37 (1): 25-30.
  15. Pelizzo G. Neonatal Ovarian Cysts. In: Lima M., Reinberg O. eds. Neonatal Surgery: Contemporary Strategies from Fetal Life to the First Year of Age. Springer Nature Switzerland AG 2019: 491-8.
  16. Shimada T., Miura K., Gotoh H., Nakayama D., Masuzaki H. Management of prenatal ovarian cysts. Early Hum Dev. 2008: 84 (6): 417-20.
  17. Sedin G, Bergquist C, Lindgren PG. Ovarian hyperstimulation syndrome in preterm infants. Pediatr Res. 1985; 19 (6): 548-52.
  18. Лейга А.В., Воловик К.Г., Чепурной М.Г., Ковалёв М.В., Хоронько Ю.В. Особенности хирургического лечения кист яичников у новорождённых. Детская хирургия. 2018; 22 (5): 250-3.
  19. Майер Ю.И., Гусейнова А.Э., Майер П.О. Новообразования яичников у новорожденных. Научный медицинский вестник Югры. 2014: 1-2 (5–6): 118–21.
  20. Cho M.J., Kim D.Y., Kim S.C. Ovarian Cyst Aspiration in the Neonate: Minimally Invasive Surgery. J Pediatr Adolesc Gynecol. 2015; 28 (5): 348-53.
  21. Zampieri N., Borruto F., Zamboni C., Camoglio F.S. Foetal and neonatal ovarian cysts: a 5-year experience. Arch Gynecol Obstet. 2008 Apr; 277 (4):303-36.
  22. Cimador M., Sireci F., Di Pace M.R., De Grazia E. One-trocar, video-assisted stripping technique for use in the treatment of large ovarian cysts in infants. J Pediatr Adolesc Gynecol. 2010; 23 (3): 168-71.
  23. Trotman G.E., Zamora M., Gomez-Lobo V. Non-surgical management of the auto-amputated adnexa in the neonate: a report on two cases. J Pediatr Adolesc Gynecol. 2014; 27 (2): 107-10.
  24. Kessler A., Nagar H., Graif M., Ben-Sira L., Miller E., Fisher D., et. al. Percutaneous drainage as the treatment of choice for neonatal ovarian cysts. Pediatr Radiol. 2006; 36 (9): 954-8.
  25. Shozu M., Akasofu K., Iida K., Harada T. Treatment of an antenatally diagnosed fetal ovarian cyst by needle aspiration during the neonatal period. Arch Gynecol Obstet. 1991; 249 (2): 103-6.
  26. Diguisto C., Winer N., Benoist G., Laurichesse-Delmas H., Potin J., Binet A., et. al. In-utero aspiration vs expectant management of anechoic fetal ovarian cysts: open randomized controlled trial. Ultrasound Obstet Gynecol. 2018; 52 (2): 159-64.
  27. Nussbaum A.R., Sanders R.C., Hartman D.S., Dudgeon D.L., Parmley T.H. Neonatal ovarian cysts: sonographic-pathologic correlation. Radiology. 1988; 168 (3): 817-21.
  28. Llorens Salvador R., Sangüesa Nebot C., Pacheco Usmayo A., Picó Aliaga S., Garcés Iñigo E. Neonatal ovarian cysts: ultrasound assessment and differential diagnosis. Radiologia. 2017; 59 (1): 31-9.
  29. Garel L., Filiatrault D., Brandt M., Grignon A., Boisvert J., Perreault G., et. al. Antenatal diagnosis of ovarian cysts: natural history and therapeutic implications. Pediatr Radiol. 1991; 21 (3): 182-4.
  30. Giorlandino C., Rivosecchi M., Bilancioni E., Bagolan P., Zaccara A., Taramanni A., et. al. Successful intrauterine therapy of a large fetal ovarian cyst. Prenat Diagn. 1990 Jul; 10 (7): 473-5.
  31. Puligandla P.S., Laberge J.M. Lethal outcome after percutaneous aspiration of a presumed ovarian cyst in a neonate. Semin Pediatr Surg. 2009; 18 (2): 119-21.
  32. Tyraskis A., Bakalis S., Scala C., Syngelaki A., Giuliani S., Davenport M., et. al. A retrospective multicenter study of the natural history of fetal ovarian cysts. J Pediatr Surg. 2018; 53 (10): 2019-22.
  33. Jeanty C., Frayer E.A., Page R., Langenburg S. Neonatal ovarian torsion complicated by intestinal obstruction and perforation, and review of the literature. J Pediatr Surg. 2010; 45 (6): 5-9.
  34. Chiaramonte C., Piscopo A., Cataliotti F. Ovarian cysts in newborns. Pediatr Surg Int. 2001; 17 (2-3): 171-4.

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