Diagnosis of fetal ovarian cysts: Monitoring and differential diagnosis?

Aim: To find better diagnostic and prognostic criteria for the prenatal evaluation of suspected fetal ovarian cysts. Method: 13 abdominal tumors were diagnosed sonographically and evaluated. The ultrasound equipment was an Acuson Computer Sonograph XP 128 with 3,5 MHz sector transducer (Acuson) and a realtime-ultrasound machine Sonoline SL 1 with 3 MHz linear transducer (Siemens). Picture documentation was made by Agfa Scopix camera, Sony printer documentation UPS or Panasonic video documentation VHS. If a cyst was aspirated, hormonal concentrations were measured by RIA (Radioimmunoassay). Protein levels electrolytes were also analysed and cytology performed. Results: Fetal ovarian cysts are rare connatal abdominal tumours of unknown pathogenesis. Typical sonographic findings are cystic structures, partially septated with homogenous inner structures and sharp outer contours. Their ovarian origin is documented by demonstrating high hormonal activity (estrogen, progestin, testosterone). Sonographic structural variations may hint at tissue trauma or a rare fetal teratoma. Conclusions: Ultrasound guided cyst puncture with fluid analysis is helpful in the differential diagnose of suspected fetal ovarian cysts. This approach will also help avoid obstetric procedures with possible prematurity complications and post-delivery abdominal surgery. Ultrasound can be used for monitor clinically asymptomatic, uncomplicated cysts, both pre-and postnatally to avoid removal of normal ovarian tissue.