Derya EROĞLU, Gonca TEKANT, Nilay AKHUN, Nilgün KAPUCUOĞLU

Fetal Over Kist Olgusu: Prenatal Tanı, Postnatal Tanısal Yaklaşim ve Sonuç

Bu yazı, fetal over kisti olarak kabul edilen bir olgunun perinatal ve postnatal sonucunu tanımlamaktadır. 29. gebelik haftasında, rutin ultrasonografik incelemede abdomende mesanenin sol superolateral tarafında çapı 15x16 mm olan anekoik kist görüldü. Diğer fetal abdominal organların normal anatomisi ve cinsiyet en olasılıklı tanı olarak ovaryen kisti, ayırıcı tanıda ise mezenterik veya duplikasyon kistini düşündürdü. Ultrasonografik takipler kist çapındaki büyümenin 36. gebelik haftasına kadar 40x22 mm olduğunu gösterdi. Doğum sonrası 4. ayda, ultrasonografik incelemede, çapı 40x39 mm olan sol taraf yerleşimli, sıvı-debris içeren kompleks over kisti görüldü ve bu bulgular hemoraji ve/veya torsiyonu düşündürdü. Bebeğe 4.5 aylıkken yapılan laparoskopik incelemede, normal sağ over ve fallop tübü ve torsiyone olmuş kistik yapıdaki sol over görülerek sol salpingo-ooferektomi yapıldı. Patoloji raporunda mikroskopik düzeyde sağlam over dokusunun olduğu belirtildi. Kist duvarındaki fibrozis, distrofik kalsifikasyon ve çok çekirdekli hücreler over torsiyonunun intrauterin olduğunu düşündürdü. Torsiyon fetal hayatta postnatal döneme göre daha sıklıkla olan en önemli komplikasyonlardan birisidir ve gonadın kaybına neden olabilir

A Case of Fetal Ovarian Cyst: Prenatal Detection, Postnatal Diagnostic Approach and Outcome

This paper describes the perinatal and postnatal outcome of a case considered to have a fetal ovarian cyst. At 29 weeks of gestation, routine ultrasound examination showed an anechoic cyst 15x16mm in diameter located in the abdomen at the left superolateral side of the bladder. The normal fetal anatomy of other abdominal organs and gender suggested an ovarian cyst as the most likely diagnosis and mesenteric or duplication cyst as differential diagnosis. Ultrasonographic follow-ups documented an increase in size to 40x22mm by 36 weeks of gestation. At postnatal 4 months, ultrasonographic scan showed a left-sided complex ovarian cyst 40x39mm in diameter containing fluid-debris levels and suggesting haemorrhage and/or torsion. At 4.5 months of age laparoscopic exploration demonstrated a normal right ovary and fallopian tube and a left ovary that had undergone torsion and remained a cystic structure. A laparoscopic left salpingo-oophorectomy was performed. Pathological examination demonstrated a microscopic amount of intact ovarian tissue. Fibrosis, dystrophic calcification and multinucleated cells were observed in the cyst wall, suggesting intrauterin torsion of the ovary. Torsion is one of the most serious complications that occur more frequently during fetal life than postnatally and may lead to loss of the gonad

Keywords:

Neonatal ovarian cyst, ovarian cysts, ovariectomy, pregnancy,

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