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. 2023 Apr 24;39(1):185.
doi: 10.1007/s00383-023-05458-2.

Ultrasonographic features associated with previous torsion and the impact of surgery in managing neonatal ovarian cysts: a 20-year single-centre retrospective study

Athanasios Tyraskis  1   2 , Joseph Davidson  2 , Jennifer Billington  3 , Simon Blackburn  3 , Joseph Curry  3 , Dhanya Mullassery  3 , Stefano Giuliani  3 , Simon Eaton  2 , Kate Cross  3 , Paolo De Coppi  4
Affiliations

Ultrasonographic features associated with previous torsion and the impact of surgery in managing neonatal ovarian cysts: a 20-year single-centre retrospective study

Athanasios Tyraskis et al. Pediatr Surg Int. .

Abstract

Purpose: To identify markers of previous ovarian torsion and outline the outcomes according to US appearance and operative management.

Methods: A retrospective single-centre review of neonatal ovarian cysts from January 2000 to January 2020. Data on postnatal cyst size and sonographic features and operative treatment were co-related with outcomes of ovarian loss and histology.

Results: 77 females were included with 22 simple and 56 complex cysts, one patient had bilateral cysts. 9/22 (41%) simple cysts regressed spontaneously in a median of 13 weeks (8-17). Complex cysts regressed spontaneously less frequently, 7/56(12%, P = 0.01), in 13 weeks (7-39). 38/56 (68%) complex and 12/22 (55%) simple cysts were treated operatively. 21/22 (95%) ovaries with initially simple cyst were salvaged compared to 20/56(36%) with initially complex cyst (P < 0.001). A fluid-debris level in 23/26 complex cysts was most associated with ovarian loss (P = 0.0006). Presence of viable ovarian stromal tissue was seen in 8/20 (40%) excised specimens during ovarian sparing procedures and in 5/30 (17%) oophorectomies for necrotic appearing ovaries.

Conclusions: Fluid-debris level on US is significantly associated with ovarian loss likely due to previous torsion. Simple cysts are viable and often regress spontaneously. The finding of viable ovarian stromal tissue in resected specimens supports attempting ovarian preservation wherever possible.

Keywords: Antenatal ultrasound; Complex ovarian cyst; Neonatal ovarian cysts; Ovarian torsion.

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Conflict of interest statement

No author has any conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Figure of cysts by greatest diameter on first postnatal scan showing simple and complex cysts and subsequent risk of ovarian loss
See this image and copyright information in PMC

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Supplementary concepts