Department of Pediatric Surgery, Ege University Faculty of Medicine, İzmir, Turkey.
Department of Pediatric Surgery, Ege University Faculty of Medicine, İzmir, Turkey.
J Pediatr Adolesc Gynecol. 2022 Feb;35(1):18-22. doi: 10.1016/j.jpag.2021.08.007. Epub 2021 Aug 25.
Antenatal ovarian torsion (AOT) is rare and requires differentiating from other congenital cystic masses of the abdomen and pelvis in neonates. In this study, it was aimed to evaluate the prenatal characteristics and postnatal outcomes of AOT. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Hospital records of patients (n = 28) with diagnosis of AOT between 2004 and 2020 were reviewed and their prenatal characteristics, postnatal examination, imaging, operative, and histopathological findings were evaluated.
There were 28 patients during the study period. In most of the patients (25/28; 89.3%) AOTs were detected prenatally. All were term babies with a mean birth weight of 3010 ± 466.6 g. Mean maternal age was 25.75 ± 3.65 years. Prenatal history was event-free in all and none had additional anomalies. Physical examination revealed mobile intra-abdominal cystic lesions in 16 (57.1%) patients. AOTs mimicked other pathologies as intestinal duplication cyst or mesenteric cyst (n = 7), complex ovarian cyst (n = 3), mature cystic teratoma (n = 3), simple renal cyst (n = 1), and ectopic kidney (n = 1) in 15 (53.6%) patients in postnatal ultrasonography. Elective laparoscopic surgery was performed in 26 (92.8%) patients. The other 2 patients required emergency open surgery because of acute symptoms. Ovaries were autoamputated in 17 (60.7%) patients. Histopathological examination revealed necrosis and dystrophic calcification in all specimens. There was neoplastic involvement in 2 patients (serous cystadenoma and gonadoblastoma). No complication occurred in the early follow-up period (mean: 73.9 ± 46.8 months).
AOTs can be detected easily during the antenatal period. Neoplastic involvement with AOTs is rare but possible. Although AOTs might mimic other cystic pathologies, it should be one of the first diagnoses to be considered, in the presence of a palpable intra-abdominal mass and complex cystic lesion in infant girls. It can be efficiently and safely managed using minimally invasive techniques.
产前卵巢扭转（AOT）较为罕见，需要与新生儿腹部和骨盆的其他先天性囊性肿块相鉴别。本研究旨在评估 AOT 的产前特征和产后结局。
设计、地点、参与者、干预措施和主要结果测量：回顾了 2004 年至 2020 年间诊断为 AOT 的 28 例患者的病历，评估了其产前特征、产后检查、影像学、手术和组织病理学发现。
研究期间共有 28 例患者。大多数（25/28；89.3%）AOT 在产前被发现。所有患儿均为足月产儿，平均出生体重为 3010±466.6g。母亲平均年龄为 25.75±3.65 岁。所有患者的产前病史均无异常，无一例存在其他异常。体格检查显示 16 例（57.1%）患者存在可移动的腹腔内囊性病变。AOT 在产后超声检查中模拟了其他病变，如肠重复囊肿或肠系膜囊肿（n=7）、复杂卵巢囊肿（n=3）、成熟囊性畸胎瘤（n=3）、单纯性肾囊肿（n=1）和异位肾（n=1）在 15 例（53.6%）患者中。26 例（92.8%）患者行择期腹腔镜手术。另外 2 例因急性症状需要急诊剖腹手术。17 例（60.7%）患者的卵巢自动切除。所有标本均显示坏死和营养不良性钙化。2 例（浆液性囊腺瘤和性腺母细胞瘤）存在肿瘤累及。在早期随访期间（平均：73.9±46.8 个月）无并发症发生。
AOT 可在产前轻松检测到。AOT 伴有肿瘤累及较为罕见，但有可能。虽然 AOT 可能模拟其他囊性病变，但在存在可触及的腹腔内肿块和婴儿女孩的复杂囊性病变时，应首先考虑诊断为 AOT。可使用微创技术进行有效且安全的治疗。
