Management of Neonatal Ovarian Cyst

Objective: There is no guideline for the treatment of neonatal ovarian cysts. The present study analyzed our clinical management of such cysts, as well as the results of treatment.
Methods: The present study involved 16 patients with neonatal ovarian cysts who had been diagnosed and treated between January 2002 and December 2016. We classified the cysts into two groups based on ultrasonographic images: (1) simple cysts (SCs)—thin-walled, round, or anechoic; (2) complex cysts (CCs), containing fluid-debris level, solid masses, or intracystic septa. We analyzed the clinical characteristics and results in the two groups.
Results: Ten of the patients had SCs and six had CCs. Fourteen were diagnosed during the prenatal stages. Of the 10 patients with SCs, eight were managed using observation only, and the cysts spontaneously resolved in all such cases. Six patients had CCs, including one with an SC that had developed into a CC. Eight of the patients underwent surgical treatment, and the surgical methods did not differ in terms of operation time or complication rate. None of the oophorectomy specimens contained any normal ovarian tissue.
Conclusion: We operated on all CCs and on SCs more than 40 mm in diameter, while patients with SCs less than 40 mm in diameter were managed using observation only, as were those in whom differential diagnosis was not possible. We must emphasize that percutaneous aspirations are safe, and we recommend transumbilical incisions, because they preserve both esthetics and ovarian function.