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Jung MY, Son OS, Lee JH, Hong YR. Preterm Ovarian Hyperstimulation Syndrome. NEONATAL MEDICINE 2015. [DOI: 10.5385/nm.2015.22.4.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Min Young Jung
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Ok Sung Son
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Jung Hyun Lee
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Yoo-Rha Hong
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
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Ahrens WA, Barrón-Rodriguez LP, McKee M, Rivkees S, Reyes-Múgica M. Clear cell adenocarcinoma of the cervix in a child without in utero exposure to diethylstilbestrol: a case report and review of the literature. Pediatr Dev Pathol 2005; 8:690-5. [PMID: 16222478 DOI: 10.1007/s10024-005-0047-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2005] [Accepted: 08/10/2005] [Indexed: 10/25/2022]
Abstract
We describe the case of a primary cervical tumor in a 6-year-old child that was originally suspected to be an embryonal rhabdomyosarcoma botryoides. Histologic analysis revealed a clear cell adenocarcinoma. Despite a direct search and questioning for maternal exposure to diethylstilbestrol, this was not documented. Clear cell adenocarcinoma is an extremely rare neoplasm that should be kept in the differential diagnosis of cervicovaginal lesions in children, even in the absence of a clinical history of in utero diethylstilbestrol exposure. We discuss the hypothesized pathogenesis and review the literature on this unusual tumor.
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Affiliation(s)
- William A Ahrens
- Department of Pathology, Yale University School of Medicine, 430 Congress Avenue, New Haven, CT 06525, USA
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Abstract
Polycystic ovaries and the associated syndrome are recognized as the most common cause of endocrine disturbances in adult women, but much less research has been performed to examine how polycystic ovary syndrome (PCOS) presents in girls and young women. Polycystic ovaries have been demonstrated in childhood, and there is evidence to show that even very young women may show symptoms and signs of the associated syndrome. Closer examination of younger populations (less-than-or-eq, slant 25 years of age), and in particular, studies of girls during the transition from puberty into early adulthood (adolescence), may provide new insights into the pathogenesis and natural history of polycystic ovaries and PCOS, and may indicate whether polycystic ovaries could potentially be considered as a marker for health screening. Consideration should be given to the management of girls and young women with polycystic ovaries and PCOS as this group may have different needs and health risks compared with older women.
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Berezowski AT, machado JC, Mendes MC, Moura MD, Duarte G, Cunha SP. Prenatal diagnosis of fetal ovarian hyperstimulation. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2001; 17:259-262. [PMID: 11309180 DOI: 10.1046/j.1469-0705.2001.00349.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A case of prenatal diagnosis of fetal ovarian hyperstimulation in a pregnancy of 35 weeks is reported. Two large cystic septate ovaries with no internal vegetations were observed in the fetal abdomen. The fetus was macrosomic and the remaining morphology was normal. Polyhydramnios and placental thickening were present, with no other macro- or microscopic alterations. The only significant maternal change detected was elevation of blood beta-human chorionic gonadotropin (beta-hCG) levels. Evaluation of the newborn confirmed the prenatal diagnosis, with progressive and spontaneous regression of fetal ovarian volume and of maternal serum beta-hCG occurring after delivery.
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Affiliation(s)
- A T Berezowski
- Ultrasound Service, Department of Gynecology and Obstetrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Abstract
A right ovarian cyst was detected in a 34-week-gestation fetus on antenatal ultrasound scan (USS). Postnatal USS confirmed the presence of the cyst and showed it to be 4.6 cm in diameter. The cyst failed to resolve after a period of conservative management, and therefore surgical removal was performed. During the operation a free autoamputated right ovarian cysts was found. The complication had not been detected preoperatively in spite of regular USS follow-up.
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Affiliation(s)
- A Aslam
- Department of Paediatric Surgery, Bristol Royal Hospital for Sick Children, England
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Giorlandino C, Bilancioni E, Bagolan P, Muzii L, Rivosecchi M, Nahom A. Antenatal ultrasonographic diagnosis and management of fetal ovarian cysts. Int J Gynaecol Obstet 1994; 44:27-31. [PMID: 7907055 DOI: 10.1016/0020-7292(94)90019-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES The aim of the present study was to evaluate the outcome of fetal ovarian cysts in relation to their ultrasonic appearance and size. METHODS Forty-two fetal ovarian cysts were diagnosed in 41 fetuses and followed with serial ultrasonograms in utero and after birth until spontaneous or surgical resolution. RESULTS Twelve fetal ovarian cysts that were echogenic at diagnosis and six that were anechoic at diagnosis but became echogenic at subsequent prenatal sonograms were all submitted to postnatal surgery. Of the remaining 24 cysts, all anechoic, four were successfully aspirated in utero, 11 resolved spontaneously after birth, and nine underwent postnatal surgery for complication. The outcome of cysts that were anechoic at diagnosis was significantly correlated with size (P = 0.01). CONCLUSIONS Echogenic fetal ovarian cysts should be always surgically removed. The outcome of anechoic cysts depends on the size at diagnosis, and serial ultrasonographic assessment is recommended; although not randomized, the present series suggests that in utero aspiration of cysts > 5 cm may prevent complication and subsequent oophorectomy.
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Abstract
Vaginal adenosis and clear cell adenocarcinoma of the vagina occurred in a 44-year-old woman after treatment for condylomata acuminata. She had no known exposure to diethylstilbestrol (DES) in utero. Biopsy-proven vaginal adenosis appeared 8 months after intravaginal 5-fluorouracil application for recurrent urogenital condylomata acuminata. Forty months later, biopsies showed residual adenosis with foci of clear cell adenocarcinoma. Although clear cell adenocarcinoma is associated with vaginal adenosis and cervical ectropion in DES-exposed women, its occurrence in adenosis after 5-fluorouracil therapy has not been reported to the authors' knowledge. In this report, this rare but serious complication of treatment of condylomata acuminata is highlighted, and the literature regarding the development of non-DES-associated vaginal adenosis is discussed.
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Affiliation(s)
- A Goodman
- Department of Gynecology, Massachusetts General Hospital, Boston
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Fetal ovarian cysts: prenatal ultrasonographic detection and postnatal evaluation and treatment. Am J Obstet Gynecol 1991; 164:874-8. [PMID: 2003554 DOI: 10.1016/0002-9378(91)90532-v] [Citation(s) in RCA: 80] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Ovarian cysts were diagnosed by antenatal ultrasonographic examination in 15 fetuses between 19 and 37 weeks' gestation. In six cases there was ultrasonographic evidence of torsion. Intracystic flocculation, which typically was deposited on the sloping part of the cyst, gave a characteristic liquid interface that was regarded as ultrasonographic evidence of torsion. All cases with evidence of torsion were managed surgically post partum, and in all patients this complication was confirmed. The remaining nine cases were followed up by repeated ultrasonograms, and in all patients disappearance of the cyst was documented within the first 6 months of life. The mean size of cysts with evidence of torsion was 5.41 +/- 0.25 cm, and the mean size of those without torsion was 4.33 +/- 0.3 cm (p less than 0.01). Histologic examination of the surgical specimen in the cases with evidence of torsion revealed follicular cysts in three cases and necrotic ovarian cysts with no specific epithelial findings in the remaining three. We recommend continuous ultrasonographic assessment of antenatally diagnosed cysts and believe that the choice of treatment depends on the appearance of the cyst and its evolution throughout pregnancy.
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Brandt ML, Luks FI, Filiatrault D, Garel L, Desjardins JG, Youssef S. Surgical indications in antenatally diagnosed ovarian cysts. J Pediatr Surg 1991; 26:276-81; discussion 281-2. [PMID: 1827651 DOI: 10.1016/0022-3468(91)90502-k] [Citation(s) in RCA: 117] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The antenatal diagnosis of ovarian cysts poses a therapeutic dilemma because the natural history of these lesions is not well known. A retrospective review from 1980 to 1989 showed 29 ovarian cysts in 27 patients diagnosed by prenatal ultrasonography performed between 28 and 36 weeks of gestation. Nineteen cysts were initially observed. Eleven cysts resolved (diameter less than 2 cm), three are decreasing, three were lost to follow-up, and two underwent resection. Eight patients underwent surgical exploration immediately following birth. The diagnosis of benign ovarian cyst was confirmed histologically in all cases. A review of the literature showed an additional 230 cases of antenatally diagnosed ovarian cysts. Simple cysts of the ovary tend to resolve spontaneously and, therefore, may be treated conservatively. Serial ultrasonography allows accurate diagnosis and long-term assessment of ovarian cysts in the neonate and may prevent unnecessary oophorectomy. Patients with cysts larger than 4 cm may be candidates for percutaneous aspiration, or should undergo removal of the cyst because of a significant risk of torsion. Complex cystic masses, symptomatic ovarian cysts, and cysts that do not resolve should be removed.
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Affiliation(s)
- M L Brandt
- Department of Surgery, Hôpital Ste-Justine, Montreal, Quebec, Canada
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D'Addario V, Volpe G, Kurjak A, Lituania M, Zmijanac J. Ultrasonic diagnosis and perinatal management of complicated and uncomplicated fetal ovarian cysts: a collaborative study. J Perinat Med 1990; 18:375-81. [PMID: 2292759 DOI: 10.1515/jpme.1990.18.5.375] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Ovarian cysts can be demonstrated in the ovaries of fetuses and full term infants at birth. Small cysts involute spontaneously during fetal life or within the first few months of life. Large cysts may cause mechanical complications or respiratory distress. Sonographic detection of fetal ovarian cysts has been reported, as well as intrauterine surgical treatment. The sonographic findings and the outcome of the smaller and the complicated cysts were studied in 25 pregnant women. Uncomplicated fetal ovarian cysts should be monitored by weekly examination until delivery. Huge ovarian cysts may be an indication for cesarean section; or, intrauterine aspiration may be the alternative. Complicated fetal ovarian cysts represent an indication for neonatal surgery.
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Affiliation(s)
- V D'Addario
- 1st Department of Obstetrics and Gynecology, University of Bari, Italy
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11
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Abstract
Ovarian cyst was diagnosed in nine fetuses by antenatal ultrasonographic examination. All deliveries were uncomplicated; two were delivered by cesarean section. The clinical condition in all cases was good. Five of the neonates with a large cyst (more than 5 cm in diameter) were managed surgically, while four were merely followed with repeated ultrasonic examinations. In three of the latter four infants, the cysts disappeared without clinical complications during the subsequent 12 months, and one has been followed for only 2 weeks. The treatment of neonatal ovarian cyst is controversial. Since small ovarian cysts are not clinically significant and may involute, conservative treatment after birth is possible. Repeated ultrasonographic examination may be used to follow small cysts in asymptomatic patients. However, surgical excision in the newborn period has been suggested for larger lesions and/or those with solid components inside the cyst before life-threatening complications occur.
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Affiliation(s)
- K Ikeda
- Department of Pediatric Surgery, Kyushu University, Fukuoka, Japan
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Amodio J, Abramson S, Berdon W, Bell J, Winchester P, Stolar C, Liebert P. Postnatal resolution of large ovarian cysts detected in utero. Report of two cases. Pediatr Radiol 1987; 17:467-9. [PMID: 3317248 DOI: 10.1007/bf02388280] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Two cases of spontaneous resolution of large ovarian cysts in newborns are presented. In both cases the cysts were detected prenatally with ultrasound. In one case the cyst disappeared before birth; in the other, the cyst resolved several weeks postnatally. Both infants also displayed labial, uterine and vaginal enlargement, signs of maternal estrogen stimulation. These large ovarian cysts are also most likely under some hormonal stimulation and may undergo spontaneous resolution and therefore obviate the need for surgery.
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Affiliation(s)
- J Amodio
- Department of Radiology, Babies Hospital, Columbia-Presbyterian Medical, New York, New York
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Holzgreve W, Winde B, Willital GH, Beller FK. Prenatal diagnosis and perinatal management of a fetal ovarian cyst. Prenat Diagn 1985; 5:155-8. [PMID: 3887359 DOI: 10.1002/pd.1970050210] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A case of a prenatally diagnosed fetal ovarian cyst is presented. The pregnancy was complicated only by polyhydramnios, and some degree of fetal bowel obstruction could be recognized on sonogram. The newborn was delivered vaginally in the 39th week of pregnancy, and the cyst was removed by laparotomy on the day of the delivery. The etiology of this rare fetal condition is unknown.
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Suita S, Ikeda K, Koyanagi T, Nakano H. Neonatal ovarian cyst diagnosed antenatally: report of two patients. JOURNAL OF CLINICAL ULTRASOUND : JCU 1984; 12:517-519. [PMID: 6436335 DOI: 10.1002/jcu.1870120814] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Crade M, Gillooly L, Taylor KJ. In utero demonstration of an ovarian cystic mass by ultrasound. JOURNAL OF CLINICAL ULTRASOUND : JCU 1980; 8:251-252. [PMID: 6769969 DOI: 10.1002/jcu.1870080315] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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