Temizkan Osman, Abike Faruk, Ayvaci Habibe, Demirag Ersan, Görücü Yasin, Isik Ecmel
Department of Obstetrics Gynecology, Sisli Etfal Education and Research Hospital, Istanbul;
Rare Tumors. 2011 Oct 21;3(4):e39. doi: 10.4081/rt.2011.e39. Epub 2011 Oct 24.
Cystic hygroma (CH) is a lymphatic malformation occurring different parts of fetal body, typically in the region of the fetal neck and axillary, abdominal wall, mediastinal, inguinal and retroperitoneal areas. CH has been associated with fetal aneuploidy, hydrops fetalis, structural malformations and intrauterine fetal death.A 24-year-old gravida 1, para 1 was admitted to our hospital at 28 weeks of gestation. Ultrasonographic examination determined 28 weeks of gestation, singleton, alive fetus who had a mass derived from the right axillary region which was extending to the anterior and posterior thoracic wall with fluid-filled cavities about 12 cm in size. There was no evidence of intrathorasic or intraabdominal extension of mass. Cordocentesis was performed and karyotype examination was normal 46 XY. The fetal demise was found after the first visit. The patient was delivered vaginally after labor induction with oxytocin infusion. The fetal autopsy confirmed the diagnosis of CH.The fetal CH carries high risk of aneuploidy and fetal malformations. Patients that have been diagnosed with CH in antenatal follow-ups should be assessed in terms of other anomalies. Fetal karyotyping should be done and the patient should be monitored for fetal hydrops. The birth should be planned in a multidisciplinary hospital and as neonatal resuscitation could be needed, pediatricians should be consulted.
囊状水瘤(CH)是一种发生于胎儿身体不同部位的淋巴管畸形,通常位于胎儿颈部、腋窝、腹壁、纵隔、腹股沟和腹膜后区域。CH与胎儿非整倍体、胎儿水肿、结构畸形及胎儿宫内死亡有关。一名24岁初产妇,孕1产1,孕28周入院。超声检查确定为孕28周,单胎,存活胎儿,右腋窝区有一肿物,延伸至胸壁前后,有大小约12 cm的液性腔隙。无肿物胸腔或腹腔内延伸的证据。进行了脐血穿刺,核型检查正常,为46,XY。首次就诊后发现胎儿死亡。经静脉滴注缩宫素引产,患者经阴道分娩。胎儿尸检确诊为CH。胎儿CH具有较高的非整倍体和胎儿畸形风险。产前检查诊断为CH的患者应评估是否存在其他异常。应进行胎儿核型分析,并监测患者有无胎儿水肿。应在多学科医院计划分娩,由于可能需要新生儿复苏,应咨询儿科医生。