Management of Neonatal Ovarian Cysts and its Effect on Ovarian Preservation

Jonathan C. Papic, Deborah F. Billmire, Frederick J. Rescorla, S. Maria E. Finnell, Charles M. Leys

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17 Scopus citations

Abstract

Background/Purpose Management of asymptomatic neonatal ovarian cysts varies. Some surgeons advocate initial observation, while others recommend immediate operation depending on cyst size and complexity. This study aims to compare outcomes of initial observation versus primary surgery, focusing on incidence of postnatal torsion and ovarian preservation. Methods A retrospective study (1997-2012) of neonates with an ovarian mass was performed. Data on cyst size, ultrasound characteristics, clinical course, complications, and pathology were extracted. Results Thirty-seven neonates with asymptomatic ovarian cysts were identified (N = 25 observed, N = 12 primary surgery). Overall, 12/25 (48%) observed had successful cyst regression, including 3/8 (38%) cysts ≥ 50 mm and 6/15 (40%) complex. 13/25 patients (52%) underwent surgery for failure of cyst regression (11/13) or concern for interval torsion (2/13). Postnatal torsion occurred in 1/25 observation patients (4%), or 1/8 (13%) with cysts ≥ 50 mm. Overall rate of ovarian preservation between groups was not statistically different [6/8 (75%) observed versus 8/9 (89%) primary surgery; P = 0.577]. Pathology found viable ovarian tissue in all oophorectomy specimens (N = 3). Conclusions Postnatal torsion is rare. A period of observation spares half of neonates from an operation, without decreasing ovarian salvage. Initial management should consist of observation, regardless of size or complex characteristics. If operative intervention is necessary, ovary preserving techniques should be utilized.

Original languageEnglish (US)
Pages (from-to)990-994
Number of pages5
JournalJournal of Pediatric Surgery
Volume49
Issue number6
DOIs
StatePublished - Jun 2014

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Keywords

  • Neonate
  • Ovarian cyst
  • Ovarian preservation
  • Ovarian salvage

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Medicine(all)

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