Introduction: Ovarian cysts are common incidental findings in term infants and, when unusually large, may result in torsion, rupture, or intestinal obstruction. Treatment options include conservative management, antenatal or neonatal cyst aspiration and laparoscopic surgery. We report a case of US-guided aspiration for the treatment of neonatal ovarian cyst with an intra-uterine torsion.
Case report: A female infant was vaginally delivered at 41 weeks of gestation and a large abdominal cyst (approximately 4.4 cm in diameter) with a fluid-debris level was detected on the antenatal and neonatal sonographies. She was healthy with no sign of acute abdomen.
Percutaneous US-guided fine needle aspiration was performed for the cyst on the 3rd day after birth and approximately 10 ml of dark red colored fluid was aspirated. The cyst was significantly decompressed, and the diameter was decreased by half.
Gradual increase of the cyst size up to 3.2 cm in diameter was detected on the successive follow-up ultrasonograms until the baby was 2 months old, and thereafter, gradual decrease until 1yr old. On the last ultrasonographic examination, the cystic component disappeared completely and an approximately 1.5 cm sized ovoid nodule like structure with peripheral tiny anechoic dots seemed like a normal ovary was demonstrated.
Conclusion: US-guided aspiration could be a treatment of choice for a large asymptomatic neonatal ovarian cyst torsion and expect a good result even though the cyst shows transient growth by fluid refilling.