Opting for conservative management over surgery for neonatal ovarian cysts

Author:

Bai Ruimiao1,Bonanni John Ross23,Guo Jinzhen1,Li Zhankui1,Yu Xiping1,Zhao Jinru4,Zeng Junan1,Garvin Gregory5,Yan Yi256ORCID

Affiliation:

1. Department of Neonatology Northwest Women's and Children's Hospital Xi'an Shaanxi Province China

2. Department of Radiology, Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada

3. Pediatric Radiology, Max Rady College of Medicine Radiology University of Manitoba Winnipeg Manitoba Canada

4. Department of Neonatal Surgery Northwest Women's and Children's Hospital Xi'an Shaanxi, Province China

5. Department of Medical Imaging St. Joseph's Health Care London London Ontario Canada

6. Department of Radiology St. Boniface Hospital Winnipeg Manitoba Canada

Abstract

AbstractObjectiveTo explore the suitability of conservative management for neonatal ovarian cysts in newborns.MethodsA retrospective cohort study was conducted, involving infants diagnosed with neonatal abdominal/pelvic cysts at two separate medical institutions from January 2015 through July 2021. Data collection included clinical characteristics, imaging results, pathological findings, and postnatal outcomes. Statistical analyses were performed using the Student's t‐test, Mann–Whitney U‐test, and receiver operating characteristic (ROC) curve.ResultsIn total, 34 cases of neonatal abdominal/pelvic cystic masses were detected, with mean birth weight of 3401 ± 515 g. Of these, 22 patients underwent postnatal cystectomy/oophorectomy. Pathological assessments revealed 16 uncomplicated cysts, 5 complex cysts, and 1 ovarian cyst with torsion complications. Notably, the cysts' dimensions at the time of surgical intervention had significantly decreased from the initial measurements (p = 0.015). The ROC curve analysis presented an area under the curve of 0.642, indicating moderate accuracy in employing cyst size as a discriminative feature to differentiate complex from simple ovarian cysts. Additionally, a short‐term follow‐up of nonsurgical cases indicated a 100% resolution rate by 24 months of age (n = 9).ConclusionGiven their predominantly benign nature, the majority of neonatal ovarian cysts seem to be amenable to conservative management. This approach remains justified for larger cysts with minimal torsion risk, as well as considering the observed reduction in cyst size at birth, which further supports the case against surgical intervention.

Publisher

Wiley

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