Differentiating congenital ovarian cysts from other abdominal cystic lesions in female infants: A study by the Canadian Consortium for Research in Pediatric Surgery (CanCORPS)

Nadia Safa, Natalie Yanchar, Pramod Puligandla, Maida Sewitch, Robert Baird, Mona Beaunoyer, Andreana Butter, Niamh Campbell, Rati Chadha, Christopher Griffiths, Sarah Jones, Manvinder Kaur, Annie Le-Nguyen, Ahmed Nasr, Nelson Piché, Hannah Piper, Pascale Prasil, Rodrigo Romao, Lisa VanHouwelingen, Paul WalesElena Guadagno, Sherif Emil, the Canadian Consortium for Research in Pediatric Surgery (CanCORPS) for the Canadian Consortium for Research in Pediatric Surgery (CanCORPS)

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The origin of congenital abdominal cysts in the female fetus often dictates management. While most arise from the ovary and are often managed non-operatively, some are non-ovarian and are frequently removed. We analyzed a national sample of female infants with congenital abdominal cysts to elucidate prenatal and postnatal factors associated with the diagnosis of a non-ovarian cyst. Methods: A retrospective cohort study of female infants who were prenatally diagnosed with abdominal cysts between 2013 and 2017 at 10 Canadian pediatric surgical centres was performed. Clinical characteristics, pre- and postnatal sonographic findings, and cyst trajectories were compared between patients with proven ovarian etiology and those with cysts arising from other organs. Results: Of 185 infants with prenatally diagnosed abdominal cysts, 22 (12%) were non-ovarian, five of which had clear non-ovarian organ of origin on prenatal ultrasound. Comparison of the other 17 cysts with 163 congenital ovarian cysts showed the following factors to be associated with a non-ovarian origin: earlier gestational age at diagnosis (23.5 vs 33.5 weeks, p <0.001), smaller diameter on first prenatal ultrasound (15.8 vs. 39.7 mm, p <0.001), change in sonographic character from simple to complex (87% vs 22%, p <0.001), and postnatal sonographic characteristics of complex cyst (87% vs. 48%, p = 0.004). Conclusion: Clear organ of origin, diagnosis earlier in gestation, smaller initial prenatal cyst diameter, and sonographic cyst character change differentiate congenital non-ovarian cysts from their ovarian counterparts. These characteristics may be used to guide diagnosis and management.

Original languageEnglish (US)
JournalJournal of Pediatric Surgery
DOIs
StateAccepted/In press - 2022
Externally publishedYes

Keywords

  • Fetal
  • Intra-abdominal cyst
  • Ovarian cyst
  • Postnatal outcome
  • Prenatal diagnosis
  • Prenatal ultrasound

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

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