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2008-08-31-10 Ovarian cyst, hemorrhagic © Manson www.thefetus.net/
Ovarian cyst, hemorrhagic 

Francois Manson, MD.

Fécamp, France.

Case report

We present a case of a left ovarian cyst diagnosed at 30 weeks. The finding was accompanied by a moderate ascites, due to which the mother was tested for TORCH and mucoviscidosis, both with negative results. No other anomaly was found. Later in pregnancy the findings had regressed spontaneously and so no further investigation was done.

Images 1, 2: 30 weeks; the images show a moderate fetal ascites.

 

Images 3, 4: 30 weeks; the image 3 shows a transverse scan of the abdomen with a heterogenous cystic lesion located in the left upper pelvis. The image 4 shows mutual position of the cyst and the urinary bladder (B).

 

Images 5, 6: 30 weeks; the image 5 represents a magnified aspect of the cystic lesion that appears round, heterogenous and thin-walled, with an intracystic hyperechoic part, probably representing a blood clot. Note the absence of the “daughter cyst sign”. The image 6 shows the aspect of the lesion, using the with HD flow color Doppler. The image shows an absence of the flow within the “tissue-like” part of the lesion, supporting the assumption of the blood clot within the lesion.

 

Image 7: 30 weeks; the image shows 3D aspect of the female fetal gender. The association of the previous images with the female fetal gender (without any other anomaly) led to the diagnosis of the left ovarian cyst.

Images 8, 9: 32 weeks; the image 8 shows a transverse scan of the fetal abdomen with complete disappearance of the fetal ascites. The image 9 shows an axial scan of the ovarian cyst. Note the sedimentation and fluid levels in it.

 

Images 10, 11: 32 weeks; the images show a gray scale (image 10) and a power Doppler (image 11) longitudinal scans os the left ovarian cyst.

 

Image 12 and video 1: The image 12 shows an aspect of the fetal ovarian cyst, using the VCI-A (Volume Contrast Imaging) function. Note the better visualization of the lesion compared with the standard images. The video shows a bowel peristalsis that helps to distinguish the limits of the immobile left ovarian mass of the fetus.

 

Image 13: 32 weeks; the image shows a regression of the size of the ovarian lesion.

The mother has delivered a healthy little girl at 37 weeks. Postnatal sonographic scans didn"t find any anomaly. The spontaneous resolution is typical for ovarian cysts which supported our final diagnosis of the left ovarian cyst complicated by the intracystic hemorrhage.

 

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