Unveiling the Uncommon: Intrauterine Diagnosis of a Fetal Ovarian Cyst – A Rare Case Report and Review of the Literature

Leo Setyadi; Peby Maulina Lestari; Nuswil Bernolian; Putri Mirani; Abarham Martadiansyah

doi:10.70716/mohr.v4i3.602

Authors

Leo Setyadi Department of Obstetrics and Gynecology, Faculty of Medicine, Sriwijaya University, Palembang, Indonesia.
Peby Maulina Lestari Department of Obstetrics and Gynecology, Faculty of Medicine, Sriwijaya University, Palembang, Indonesia.
Nuswil Bernolian Department of Obstetrics and Gynecology, Faculty of Medicine, Sriwijaya University, Palembang, Indonesia.
Putri Mirani Department of Obstetrics and Gynecology, Faculty of Medicine, Sriwijaya University, Palembang, Indonesia.
Abarham Martadiansyah Department of Obstetrics and Gynecology, Faculty of Medicine, Sriwijaya University, Palembang, Indonesia.

DOI:

https://doi.org/10.70716/mohr.v4i3.602

Keywords:

Primigravida, ovarian cystic neoplasm, fetus, prenatal ultrasonography

Abstract

Fetal Ovarian Cysts (FOCs) are a rare condition that can be detected through prenatal ultrasonography. This report discusses a case of a preterm primigravida with suspected FOCs, identified via ultrasound at 34 weeks of gestation. Conservative management with serial monitoring was implemented. Spontaneous delivery occurred at 36 weeks, resulting in a live birth, followed by postnatal monitoring. Fetal ovarian cysts result from hormonal stimulation, leading to abnormal follicular growth and fluid-filled cyst formation. Detection is primarily through prenatal ultrasound, with MRI aiding further evaluation. Management depends on cyst size and characteristics, with conservative monitoring for smaller cysts and intervention for larger or complicated cases. Most fetal ovarian cysts regress spontaneously postnatally, though persistent hormone levels may prolong their presence. Conservative management is often effective, with postnatal monitoring essential to prevent complications and unnecessary surgery. This case highlights the importance of early detection, close monitoring, and a multidisciplinary approach in managing FOCs.

Downloads

Download data is not yet available.

References

Akın, M. A., Akın, L., Özbek, S., Tireli, G., Kavuncuoğlu, S., Sander, S., Akçakuş, M., Güneş, T., Öztürk, M. A., & Kurtoğlu, S. (2010). Fetal-neonatal ovarian cysts: Their monitoring and management: A retrospective evaluation of 20 cases and review of the literature. Journal of Clinical Research in Pediatric Endocrinology, 2(1), 28–33. https://doi.org/10.4274/jcrpe.v2i1.28

Bascietto, F., Liberati, M., Marrone, L., Khalil, A., Pagani, G., Gustapane, S., Leombroni, M., Buca, D., Flacco, M. E., Rizzo, G., Acharya, G., Manzoli, L., & D'Antonio, F. (2017). Outcome of fetal ovarian cysts diagnosed on prenatal ultrasound examination: Systematic review and meta-analysis. Ultrasound in Obstetrics & Gynecology, 50(1), 20–31. https://doi.org/10.1002/uog.16002

Catania, V. D., Briganti, V., Di Giacomo, V., Miele, V., Signore, F., de Waure, C., Calabrò, G. E., & Calisti, A. (2016). Fetal intra-abdominal cysts: Accuracy and predictive value of prenatal ultrasound. Journal of Maternal-Fetal & Neonatal Medicine, 29(10), 1691–1699. https://doi.org/10.3109/14767058.2015.1059812

Chen, L., Hu, Y., Hu, C., & Wen, H. (2020). Prenatal evaluation and postnatal outcomes of fetal ovarian cysts. Prenatal Diagnosis, 40(10), 1258–1264.

Cheng, Y. (2021). Ovarian cysts. American Journal of Obstetrics and Gynecology, 225, B23–B25.

Devriendt, S., Heyman, S., Leyman, P., Meeussen, C., & Vervloessem, D. (2024). Prenatal ovarian torsion: Diagnosis and management in the newborn. Journal of Pediatric Surgery Open, 6, 100117. https://doi.org/10.1016/j.ypsc.2024.100117

Diguisto, C., Winer, N., Benoist, G., et al. (2018). In-utero aspiration vs expectant management of anechoic fetal ovarian cysts: Open randomized controlled trial. Ultrasound in Obstetrics & Gynecology, 52(2), 159–164. https://doi.org/10.1002/uog.18910

Di Lorenzo, A., et al. (2020). Pathophysiology of fetal ovarian cysts. Journal of Maternal-Fetal & Neonatal Medicine, 33(3), 435–440.

Fägerquist, M., Fägerquist, U., Odén, A., & Blomberg, S. G. (2001). Fetal urine production and accuracy when estimating fetal urinary bladder volume. Ultrasound in Obstetrics & Gynecology, 17(2), 132–139. https://doi.org/10.1046/j.1469-0705.2001.00294.x

Hara, T., Mimura, K., Endo, M., et al. (2021). Diagnosis, management, and therapy of fetal ovarian cysts detected by prenatal ultrasonography: A report of 36 cases and literature review. Diagnostics, 11(12), 2224. https://doi.org/10.3390/diagnostics11122224

Heling, K. S., et al. (2018). Postnatal complications in fetal ovarian cysts: A retrospective study. Neonatology, 113(2), 113–119.

Isaacs, H. (2007). Fetal and neonatal ovarian cysts. Journal of Pediatric Surgery, 42(5), 1025–1031.

Lawrence, A. E., Fallat, M. E., Hewitt, G., et al. (2020). Understanding the value of tumor markers in pediatric ovarian neoplasms. Journal of Pediatric Surgery, 55, 122–125.

Liu, X., Ding, G., Tian, W., Liu, X., Fu, T., Liu, H., & Geng, L. (2025). Intrauterine ovarian torsion with autoamputation and intra-abdominal wandering mass: a report of three cases and literature review. Frontiers in Medicine, 12, 1509477.

Nakamura, M., et al. (2019). Expectant management of fetal ovarian cysts: Prognosis and ovarian preservation. Journal of Maternal-Fetal & Neonatal Medicine, 32(4), 646–651.

Nemec, U., Nemec, S. F., Bettelheim, D., et al. (2022). Ovarian cysts on prenatal MRI. European Journal of Radiology, 81, 1937–1944.

Ozyuncu, O., Canpolat, F. E., Ciftci, A. O., Yurdakok, M., Onderoglu, L. S., & Deren, O. (2010). Perinatal outcomes of fetal abdominal cysts and comparison of prenatal and postnatal diagnoses. Fetal Diagnosis and Therapy, 28(3), 153–159. https://doi.org/10.1159/000318191

Papic, J. C., Billmire, D. F., Rescorla, F. J., et al. (2014). Management of neonatal ovarian cysts and its effect on ovarian preservation. Journal of Pediatric Surgery, 49, 990–993.

Rotar, I. C., Tudorache, S., Staicu, A., et al. (2021). Fetal ovarian cysts: Prenatal diagnosis using ultrasound and MRI, management and postnatal outcome—Our center's experience. Diagnostics, 12(1), 89. https://doi.org/10.3390/diagnostics12010089

Saeed, H., Hong, L., Smith, N., & Shaman, M. (2020). Ovarian torsion in utero diagnosed at 37 weeks of pregnancy: A case report. Case Reports in Women's Health, 27, e00232. https://doi.org/10.1016/j.crwh.2020.e00232

Souganidis, E., Chen, A., & Friedlaender, E. (2021). Symptomatic persistent fetal ovarian cysts. Pediatric Emergency Care, 37, e672–e674.

Toker Kurtmen, B., Divarci, E., Ergun, O., Ozok, G., & Celik, A. (2022). The role of surgery in antenatal ovarian torsion: Retrospective evaluation of 28 cases and review of the literature. Journal of Pediatric and Adolescent Gynecology, 35(1), 18–22. https://doi.org/10.1016/j.jpag.2021.08.007

Trinh, T. W., & Kennedy, A. M. (2015). Fetal ovarian cysts: Review of imaging spectrum, differential diagnosis, management, and outcome. Radiographics, 35(3), 621–635. https://doi.org/10.1148/rg.2015140177

Tu, C. Y. (2017). Ultrasound and differential diagnosis of fetal abdominal cysts. Experimental and Therapeutic Medicine, 13(1), 302–306. https://doi.org/10.3892/etm.2016.3948

Tyraskis, A., Bakalis, S., Scala, C., et al. (2017). A retrospective multicenter study of the natural history of fetal ovarian cysts. Journal of Pediatric Surgery, 53(11), 2019–2022. https://doi.org/10.1016/j.jpedsurg.2017.10.036