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Chen H, Jia M, Yang S, Zou J, Xiao X. Umbilical cord cysts: Classification, diagnosis, prognosis, and pregnancy recommendations. Int J Gynaecol Obstet 2024; 164:823-829. [PMID: 37489030 DOI: 10.1002/ijgo.15006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 06/22/2023] [Accepted: 07/04/2023] [Indexed: 07/26/2023]
Abstract
Umbilical cord cysts (UCCs)-cysts located in the umbilical cord that are derived from an abnormal embryonic development process-are typically an incidental discovery during prenatal ultrasound. It can be described as either a pseudocyst or a true UCC, which results from focal edema or degeneration of Wharton jelly or the remnants of embryonic development, respectively. Due to the relative rarity of the UCC, the clinical guidance of UCCs is not yet available. Herein, the aim of this paper is to discuss the classification, diagnosis, prognosis, and clinical management of UCCs through a literature review, in order to improve the understanding of UCCs among clinical obstetricians and pediatricians.
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Affiliation(s)
- Huiling Chen
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Mingzhu Jia
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Shuqi Yang
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Juan Zou
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
- Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Xue Xiao
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
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Qian Y, Hu T, Zhang Z, Xiao L, Wang J, Hu R, Liao N, Liu Z, Wang H, Liu S. Prenatal diagnosis with chromosome microarray analysis and pregnancy outcomes of fetuses with umbilical cord cysts. J Matern Fetal Neonatal Med 2023; 36:2203793. [PMID: 37088564 DOI: 10.1080/14767058.2023.2203793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
OBJECTIVE To investigate the prenatal diagnostic value of chromosome microarray analysis (CMA) in fetuses with isolated or non-isolated umbilical cord cysts (UCCs) of various locations and numbers. METHODS Between November 2015 and November 2021, 45 pregnant women carrying fetuses with UCCs underwent amniocentesis and CMA. Fetal prognoses were followed from 6 months to 5 years. RESULTS Five cases (11.1%, 5/45) of chromosomal aberrations were detected. No significant difference in total chromosome abnormalities was found between fetuses with isolated and non-isolated UCCs (13.3% [2/15] vs 10% [3/30]; p > .999). No common autosomal aneuploidies were found in fetuses with isolated UCCs. At follow-up, among 45 fetuses, there were 11 (24.4%) pregnancy terminations, 26 (57.8%) live healthy births, 4 (8.9%) postnatal UCC-related surgeries, and 4 (8.9%) live births of fetuses with other diseases. The frequency of postnatal surgeries of the infants with UCCs located adjacent to the anterior abdominal wall was higher than those located adjacent to the fetal surface of the placenta (30.8% [4/13] vs 0% [0/22]; p = .014). All 26 live healthy neonates and 4 neonates that underwent postnatal surgery had an overall good prognosis. CONCLUSIONS For fetuses with isolated or non-isolated UCC, CMA could be a choice for parents after providing detailed information. Even when surgery was required, pregnancy outcomes and short- and long-term prognoses for fetuses with UCCs were favorable.
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Affiliation(s)
- Yanping Qian
- Department of Medical Genetics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), China
| | - Ting Hu
- Department of Medical Genetics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), China
| | - Zhu Zhang
- Department of Medical Genetics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), China
| | - Like Xiao
- Department of Medical Genetics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), China
| | - Jiamin Wang
- Department of Medical Genetics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), China
| | - Rui Hu
- Department of Medical Genetics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), China
| | - Na Liao
- Department of Medical Genetics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), China
| | - Zhushu Liu
- Department of Medical Genetics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), China
| | - He Wang
- Department of Medical Genetics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), China
| | - Shanling Liu
- Department of Medical Genetics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), China
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Liu Q, Wei R, Lu J, Ding H, Yi H, Guo L, Wu J. A Retrospective Cohort Analysis of the Genetic Assay Results of Foetuses with Isolated and Nonisolated Umbilical Cord Cyst. Int J Gen Med 2022; 15:5775-5784. [PMID: 35770052 PMCID: PMC9236164 DOI: 10.2147/ijgm.s358864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/16/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To analyse the risk of clinical chromosomal abnormalities in foetuses with umbilical cord cysts. Methods Data from all genetic assays that were performed as part of invasive prenatal diagnoses of umbilical cord cysts between October 2014 and June 2021 were retrospectively collected from Guangdong Women and Children Hospital. We compared the differences in genetic assay findings in isolated and nonisolated umbilical cord cyst cohorts. Results A total of 49 singleton pregnancies and 2 foetuses that were one of the cotwins in monochorionic twin pregnancies were enrolled in the cohort; 20 isolated and 31 nonisolated umbilical cord cysts were identified in the cohort. One foetus (5%, 1/20) in the isolated umbilical cord cyst group showed chromosomal abnormalities and 17p12 microduplication. Twelve cases (38.7%, 12/31) of chromosomal abnormalities, including seven cases of trisomy 18, two cases of trisomy 13 and three cases of microdeletion, were identified in the nonisolated umbilical cord cyst group. The incidences of chromosomal abnormalities between the two groups were significantly different (1/20, 5% vs 13/31, 38.7%, p=0.003). There was no relative pathological medical exome sequencing finding in the three foetuses suffering from nonisolated umbilical cord cysts whose parents chose to undergo chromosomal microarray analysis (CMA) and medical exome sequencing. Conclusion This retrospective cohort study evaluated the value of CMA in foetuses with umbilical cord cysts and suggested that copy number variants (CNVs) may be the basic genetic aetiological factors that should be considered for diagnostic evaluation. We recommended CMA as a basic genetic evaluation in cases of umbilical cord cysts, especially in nonisolated cases.
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Affiliation(s)
- Qian Liu
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou City, Guangdong Province, People’s Republic of China
| | - Ran Wei
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou City, Guangdong Province, People’s Republic of China
| | - Jian Lu
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou City, Guangdong Province, People’s Republic of China
| | - Hongke Ding
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou City, Guangdong Province, People’s Republic of China
| | - Hui Yi
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou City, Guangdong Province, People’s Republic of China
| | - Li Guo
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou City, Guangdong Province, People’s Republic of China
| | - Jing Wu
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou City, Guangdong Province, People’s Republic of China
- Correspondence: Jing Wu, Department of Medical Genetics Center, Guangdong Women and Children Hospital, NO. 521 Xingnan Road, Panyu District, Guangzhou city, Guangdong Province, People’s Republic of China, Tel +86 20-39151548, Email
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Sherer DM, Al-Haddad S, Cheng R, Dalloul M. Current Perspectives of Prenatal Sonography of Umbilical Cord Morphology. Int J Womens Health 2021; 13:939-971. [PMID: 34703323 PMCID: PMC8541738 DOI: 10.2147/ijwh.s278747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/04/2021] [Indexed: 12/15/2022] Open
Abstract
The umbilical cord constitutes a continuation of the fetal cardiovascular system anatomically bridging between the placenta and the fetus. This structure, critical in human development, enables mobility of the developing fetus within the gestational sac in contrast to the placenta, which is anchored to the uterine wall. The umbilical cord is protected by unique, robust anatomical features, which include: length of the umbilical cord, Wharton’s jelly, two umbilical arteries, coiling, and suspension in amniotic fluid. These features all contribute to protect and buffer this essential structure from potential detrimental twisting, shearing, torsion, and compression forces throughout gestation, and specifically during labor and delivery. The arterial components of the umbilical cord are further protected by the presence of Hyrtl’s anastomosis between the two respective umbilical arteries. Abnormalities of the umbilical cord are uncommon yet include excessively long or short cords, hyper or hypocoiling, cysts, single umbilical artery, supernumerary vessels, rarely an absent umbilical cord, stricture, furcate and velamentous insertions (including vasa previa), umbilical vein and arterial thrombosis, umbilical artery aneurysm, hematomas, and tumors (including hemangioma angiomyxoma and teratoma). This commentary will address current perspectives of prenatal sonography of the umbilical cord, including structural anomalies and the potential impact of future imaging technologies.
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Affiliation(s)
- David M Sherer
- The Division of Maternal Fetal Medicine, The Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA
| | - Sara Al-Haddad
- The Division of Maternal Fetal Medicine, The Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA
| | - Regina Cheng
- The Division of Maternal Fetal Medicine, The Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA
| | - Mudar Dalloul
- The Division of Maternal Fetal Medicine, The Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA
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Orlandi G, Toscano P, Di Meglio L, Di Meglio L, Di Meglio A. Omphalocele Secondary to Spontaneous Rupture of Allantoic Cyst in the Third Trimester of Pregnancy. Case Rep Obstet Gynecol 2021; 2021:6940685. [PMID: 34589243 PMCID: PMC8476282 DOI: 10.1155/2021/6940685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/31/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We report the first case in which the onset of omphalocele was after the spontaneous rupture of an allantoic cyst. We hypothesize a causal link between the spontaneous rupture of the cyst and the herniation of the viscera. Case Presentation. A 36-year-old woman was diagnosed with an allantoic cyst during the first trimester. The allantoic cyst underwent spontaneous rupture during the 32nd week of gestation, and an omphalocele developed secondary to the cyst's rupture. Two days after birth, the peritoneum covering intestinal loops broke spontaneously and the newborn underwent successful urgent surgery. CONCLUSIONS This case may suggest that the relative benignity of the allantoid cysts may recommend a close ultrasound follow-up in order to identify the onset of any complications, as a late third trimester onset of omphalocele. Prenatal diagnosis of such complications may allow multidisciplinary management of the pregnancy with planned cesarean section, prenatal pediatric surgery consultation, and neonatal surgery.
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Affiliation(s)
- Giuliana Orlandi
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Paolo Toscano
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
- Diagnostica Ecografica e Prenatale di A. Di Meglio, Naples, Italy
| | - Lavinia Di Meglio
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
- Diagnostica Ecografica e Prenatale di A. Di Meglio, Naples, Italy
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Suzuki T, Yamamoto Y, Nakamura H, Sei-Okawa K, Maruyama Y, Takeda J, Makino S, Yamataka A, Itakura A. Fetal umbilical cord cyst may evolve to omphalocele during pregnancy. JOURNAL OF CLINICAL ULTRASOUND : JCU 2020; 48:181-183. [PMID: 31724176 DOI: 10.1002/jcu.22786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/26/2019] [Accepted: 10/02/2019] [Indexed: 06/10/2023]
Abstract
Omphalocele is rarely complicated by umbilical cord cysts. In our case, an umbilical cord cyst and fetal ascites were detected at 26 weeks' gestation in a fetus with trisomy 13. This changed to omphalocele with subsequently absorbed fetal ascites at 35 weeks' gestation. We propose two hypotheses. The abdominal wall may have been physically pierced or an omphalocele might have preexisted, and the intestinal tract in the hernia sac was pushed by fetal ascites.
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Affiliation(s)
- Toshifumi Suzuki
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yuka Yamamoto
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hiroki Nakamura
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kiguna Sei-Okawa
- Department of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yojiro Maruyama
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Jun Takeda
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Shintaro Makino
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Atsuyuki Yamataka
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Atsuo Itakura
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
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She F, Dong S, Yuan B, Gao X. Diagnosis of fetal megacystis with chromosomal abnormality by 2D prenatal ultrasound: A case report. Medicine (Baltimore) 2017; 96:e8589. [PMID: 29145274 PMCID: PMC5704819 DOI: 10.1097/md.0000000000008589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE The pathogenesis of fetal megacystis is divided into obstructive and nonobstructive. Megacystis combined with chromosomal abnormalities is rare and most of the cases are nonobstructive. PATIENT CONCERNS The fetus showed posterior urethral obstructive megacystis with features of bladder enlargement, "keyhole" feature, and thick bladder wall. DIAGNOSES Here, we present a case of fetal megacystis diagnosed by ultrasound at pregnancy week 15+2 and with multisystem abnormalities. OUTCOMES Moreover, the fetus showed edema, umbilical cord cyst, cardiac dysplasia, hook-shaped hand, and strephenopodia. These abnormalities strongly suggested chromosomal abnormalities. The fetus was diagnosed with trisomy 18 by amniocentesis. Posterior urethral obstructive megacystis was confirmed by pathology. LESSONS In conclusion, this case suggests that in the presence of fetal megacystis and multisystem abnormalities, causes should be investigated and the possibility of chromosomal abnormalities should be considered in the presence of multisystem developmental abnormalities.
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Affiliation(s)
- Fuman She
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital
| | | | - Bibo Yuan
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital
| | - Xiaoli Gao
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital
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Yamashita E, Yashiro K, Suzuki S. Prenatal ultrasonographic findings of large pseudocysts and edema of the umbilical cord. J Med Ultrason (2001) 2011; 38:59-61. [PMID: 27278342 DOI: 10.1007/s10396-010-0275-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2010] [Accepted: 06/07/2010] [Indexed: 11/29/2022]
Affiliation(s)
- Eriko Yamashita
- Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, 5-11-12 Tateishi, Katsushika-ku, Tokyo, 124-0012, Japan
| | - Kentaro Yashiro
- Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, 5-11-12 Tateishi, Katsushika-ku, Tokyo, 124-0012, Japan
| | - Shunji Suzuki
- Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, 5-11-12 Tateishi, Katsushika-ku, Tokyo, 124-0012, Japan.
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Haino K, Serikawa T, Itsukaichi M, Numata M, Kikuchi A, Kojima K, Matsunaga M, Takakuwa K, Tanaka K. Large pseudocyst of the umbilical cord detected in the second trimester. J Med Ultrason (2001) 2010; 37:213-5. [PMID: 27278197 DOI: 10.1007/s10396-010-0272-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Accepted: 05/24/2010] [Indexed: 10/19/2022]
Abstract
We present a case of a large umbilical cord cyst detected at 21 weeks of gestation. Serial ultrasonographic examination revealed a single umbilical artery and progression of the cystic mass. A 2,842-g male infant was delivered at 37 weeks of gestation, and we confirmed that the umbilical cord cyst was a pseudocyst in our pathological examination. This case demonstrated an uneventful course of pregnancy despite the large umbilical cord pseudocyst.
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Affiliation(s)
- Kazufumi Haino
- Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi, Chuo, Niigata, 951-8510, Japan.
| | - Takehiro Serikawa
- Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi, Chuo, Niigata, 951-8510, Japan
| | - Mina Itsukaichi
- Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi, Chuo, Niigata, 951-8510, Japan
| | - Masahiro Numata
- Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi, Chuo, Niigata, 951-8510, Japan
| | - Akira Kikuchi
- Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi, Chuo, Niigata, 951-8510, Japan
| | - Kinuko Kojima
- Department of Pediatrics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Masamichi Matsunaga
- Department of Pediatrics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Koichi Takakuwa
- Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi, Chuo, Niigata, 951-8510, Japan
| | - Kenichi Tanaka
- Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi, Chuo, Niigata, 951-8510, Japan
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Zangen R, Boldes R, Yaffe H, Schwed P, Weiner Z. Umbilical cord cysts in the second and third trimesters: significance and prenatal approach. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2010; 36:296-301. [PMID: 20131340 DOI: 10.1002/uog.7576] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES This study was carried out to determine the prognosis, and the clinical approach, in fetuses with umbilical cord cysts, during the second and third trimesters of gestation, according to our experience and data in the current literature. METHODS We identified 10 fetuses with umbilical cord cysts that were diagnosed during the second and third trimesters of pregnancy at three referral centers. All underwent detailed ultrasound evaluation at the time of diagnosis and during follow-up. Prenatal karyotype testing was offered to all women. A MEDLINE review of the literature published from 1980 to 2009 was carried out to identify previous studies and case reports of fetuses with umbilical cord cysts. RESULTS In our series of 10 cases, significant additional abnormalities were observed in two during a detailed sonogram. In one case, trisomy 18 was diagnosed, leading to pregnancy termination, and in the other case a neonate with heart defects and a normal karyotype was born. These results differ from those reported in the literature, in which the association between second- and third-trimester umbilical cord cysts and fetal anomalies ranged from 38 to 100%. CONCLUSIONS In our study, as in other publications, an association was found between the presence of second- and third-trimester umbilical cord cysts and fetal anomalies. The strong association between second- and third-trimester umbilical cord cysts and aneuploidy in the literature seems to be biased, mainly because of the tendency to report abnormal cases. When these findings are accompanied by additional sonographic abnormalities, the association with aneuploidy is clear and should be an indication for fetal karyotype testing.
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Affiliation(s)
- R Zangen
- Department of Obstetrics and Gynecology, Bikur Holim Hospital, Jerusalem, Israel.
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Abstract
BACKGROUND Most umbilical cord masses detected by sonography are angiomyxomas, hematomas, or teratomas. Cord teratomas arise from totipotent stem cells and contain tissue from the three germ-cell layers. Tumour components are foreign to surrounding tissue and may have a polymorphic presentation. CASE We report a case of a suspected umbilical cord teratoma, identified by sonographic and magnetic resonance imaging, which in fact camouflaged an umbilical cord hernia. The natural history of an omphalocele and umbilical cord hernia dictates the presence of such anterior abdominal wall defects by approximately 12 weeks' gestation, once the gut returns from the peritoneal space within the umbilical stalk to the peritoneal cavity. Adipose tissue is not described as a classic finding in an omphalocele or umbilical cord hernia. CONCLUSION Our case of umbilical cord hernia is the first described as strictly distal to, and not contained within, the abdominal wall cord insertion site, and to contain fat, thereby mimicking a cord teratoma.
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Pal K, Ashri H, Al-Ghazal FA. Allantoic cyst and patent urachus. Indian J Pediatr 2009; 76:221-3. [PMID: 19057858 DOI: 10.1007/s12098-008-0218-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2007] [Accepted: 01/01/2008] [Indexed: 11/29/2022]
Abstract
Allantoic cysts of the umbilical cord are extremely rare anomalies. Only few cases have been reported in the postnatal life. The etiopathogenesis is still obscure. We describe a case of allantoic cyst and patent urachus in a newborn associated with hypospadias and meatal obstruction. We also present the review of literature regarding this entity, embryology and etiopathogenesis.
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Affiliation(s)
- Kamalesh Pal
- Department of Pediatric Surgery, Maternity and Children's Hospital, Al Ahsa, Kingdom of Saudi Arabia.
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Kobayashi S, Santos JFLD, Fernandes VM, Chammas MC, Cerri GG. Correlação entre o achado ultra-sonográfico isolado de cisto de cordão umbilical e anomalias fetais. Radiol Bras 2008. [DOI: 10.1590/s0100-39842008000300006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Correlacionar o achado ultra-sonográfico isolado de cisto de cordão umbilical com anomalias fetais, como cromossomopatias e alterações estruturais. Segundo a literatura médica, as implicações clínicas do achado ultra-sonográfico de cisto de cordão nos segundo e terceiro trimestres de gestação estão bem estabelecidas, entretanto, quando no primeiro trimestre, o significado ainda permanece controverso. MATERIAIS E MÉTODOS: Foi realizado estudo retrospectivo de gestantes da população geral, consecutivas, com fetos únicos e vivos, que apresentavam apenas o achado de cisto de cordão umbilical, num período de dez anos (1996-2006). Em todos os casos foram realizados exames ultra-sonográficos para o rastreamento de anomalias fetais após o diagnóstico de cisto de cordão. Os recém-nascidos e o cordão umbilical foram examinados após o parto para se verificar a presença de anomalias. RESULTADOS: Foram estudados nove casos que apresentavam cisto de cordão umbilical como único achado, sem outros marcadores ultra-sonográficos de anomalias fetais. Detectaram-se dois casos no primeiro trimestre de gestação e sete nos segundo e terceiro trimestres. Dois casos foram submetidos a estudo citogenético fetal, por meio de amniocentese. Nenhum recém-nascido apresentou anomalias estruturais ou aneuploidia. CONCLUSÃO: O achado ultra-sonográfico isolado de cisto de cordão umbilical não significou aumento de risco para anomalias estruturais ou aneuploidias.
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Ratan SK, Rattan KN, Kalra R, Maheshwari J, Parihar D, Ratan J. Omphalomesenteric duct cyst as a content of omphalocele. Indian J Pediatr 2007; 74:500-2. [PMID: 17526966 DOI: 10.1007/s12098-007-0087-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A rare occurrence of an omphalomesenteric duct cyst in an exomphalos minor sac is reported herein. The noteworthy points in this case were an unusual presentation of the rarest variety of umbilical cord cyst. The tapering intra-abdominal end of the cyst was found to be attached to the ileal mesentry, thereby simulating a herniating mesenteric cyst till the histolopathological report resolved the issue.
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Affiliation(s)
- Simmi K Ratan
- Department of Pediatrics Surgery, Pt B.D. Sharma PGIMS, Rohtak, Haryana, India.
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15
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Bunch PT, Kline-Fath BM, Imhoff SC, Calvo-Garcia MA, Crombleholme TM, Donnelly LF. Allantoic cyst: a prenatal clue to patent urachus. Pediatr Radiol 2006; 36:1090-5. [PMID: 16847597 DOI: 10.1007/s00247-006-0260-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2006] [Revised: 05/19/2006] [Accepted: 06/05/2006] [Indexed: 11/30/2022]
Abstract
A patent urachus, which is typically diagnosed as leakage from the umbilicus postnatally, can present as an allantoic cyst in the umbilical cord antenatally. We report a case of a patent urachus with an allantoic cyst diagnosed via fetal MR imaging at 24 weeks' gestation. Early detection allowed for appropriate counseling and prompt corrective surgery after birth.
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Affiliation(s)
- Paul T Bunch
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039, USA
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16
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Prada Arias M, García Lorenzo F, Montero Sánchez M, Muguerza Vellibre R. Enteric duplication cyst resembling umbilical cord cyst. J Perinatol 2006; 26:368-70. [PMID: 16724077 DOI: 10.1038/sj.jp.7211520] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We report a case of a neonatal male with a prenatal diagnosis of umbilical cord cyst that was finally diagnosed as an ileal duplication cyst after post-natal surgical exploration of the umbilical mass. To our knowledge, a similar case has never been reported previously. Although this form of presentation of enteric duplication cyst is exceptional, it should be taken into consideration when evaluating suspected umbilical cord cysts.
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Affiliation(s)
- M Prada Arias
- Service of Pediatric Surgery, University Hospital Xeral-Cíes, Vigo, Spain.
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