Management of neonatal ovarian cysts: a 10-year single-center experience.

INTRODUCTION

Postnatal management of ovarian cysts in neonates is debated.

METHODS

A retrospective analysis of neonates diagnosed with ovarian mass at a tertiary referral center (Jan 2014-May 2024).

RESULTS

64 neonates (1 day-8 months; mean: 8.2 weeks) were diagnosed with 65 ovarian masses ≥ 20 mm (mean: 44.2 mm; range: 20-81 mm). Prematurity was present in 31% (n = 20). Primary surgery was performed in 11 cases due to severe symptoms/uncertain mass origin; 3 underwent percutaneous puncture; 50 were observed. Of these, 37/50 (74%) had cyst regression within 18 months, including 7 complex cysts (19%). Delayed involution occurred in 6/50 (12%) observed. Both complex morphology and larger cyst size were significantly associated with delayed regression (p = 0.0005, p = 0.0045, respectively). 8/50 (16%) underwent intervention for cyst enlargement (2 laparoscopies, 5 punctures) or concern for interval torsion (1 laparotomy). No confirmed postnatal torsion or hemorrhagic complications occurred in the observation group. One patient required a repeat procedure after percutaneous reduction. No significant association was found between lesion size and the symptoms of recent adnexal torsion (p = 0.99).

CONCLUSIONS

Observation is safe for asymptomatic ovarian cysts. Postnatal torsion is rare but can occur regardless of lesion size, including patients with no prior history of ovarian cysts.