Study Objective

Antenatal ovarian torsion (AOT) is rare and requires differentiating from other congenital cystic masses of the abdomen and pelvis in neonates. In this study, it was aimed to evaluate the prenatal characteristics and postnatal outcomes of AOT.

Design, Setting, Participants, Interventions, and Main Outcome Measures

Hospital records of patients (n = 28) with diagnosis of AOT between 2004 and 2020 were reviewed and their prenatal characteristics, postnatal examination, imaging, operative, and histopathological findings were evaluated.

Results

There were 28 patients during the study period. In most of the patients (25/28; 89.3%) AOTs were detected prenatally. All were term babies with a mean birth weight of 3010 ± 466.6 g. Mean maternal age was 25.75 ± 3.65 years. Prenatal history was event-free in all and none had additional anomalies. Physical examination revealed mobile intra-abdominal cystic lesions in 16 (57.1%) patients. AOTs mimicked other pathologies as intestinal duplication cyst or mesenteric cyst (n = 7), complex ovarian cyst (n = 3), mature cystic teratoma (n = 3), simple renal cyst (n = 1), and ectopic kidney (n = 1) in 15 (53.6%) patients in postnatal ultrasonography. Elective laparoscopic surgery was performed in 26 (92.8%) patients. The other 2 patients required emergency open surgery because of acute symptoms. Ovaries were autoamputated in 17 (60.7%) patients. Histopathological examination revealed necrosis and dystrophic calcification in all specimens. There was neoplastic involvement in 2 patients (serous cystadenoma and gonadoblastoma). No complication occurred in the early follow-up period (mean: 73.9 ± 46.8 months).

Conclusion

AOTs can be detected easily during the antenatal period. Neoplastic involvement with AOTs is rare but possible. Although AOTs might mimic other cystic pathologies, it should be one of the first diagnoses to be considered, in the presence of a palpable intra-abdominal mass and complex cystic lesion in infant girls. It can be efficiently and safely managed using minimally invasive techniques.

中文翻译：

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手术在产前卵巢扭转中的作用：28例回顾性评价及文献复习

学习目标

产前卵巢扭转 (AOT) 很少见，需要与新生儿腹部和骨盆的其他先天性囊性肿块相鉴别。本研究旨在评估 AOT 的产前特征和产后结局。

设计、设置、参与者、干预措施和主要结果测量

回顾了 2004 年至 2020 年间诊断为 AOT 的患者（n = 28）的医院记录，并评估了他们的产前特征、产后检查、影像学、手术和组织病理学结果。

结果

研究期间共有28名患者。大多数患者（25/28；89.3%）在产前检测到 AOT。所有都是足月婴儿，平均出生体重为 3010 ± 466.6 g。平均母亲年龄为 25.75 ± 3.65 岁。产前病史全部无事件，无其他异常。体格检查发现 16 名 (57.1%) 患者有可移动的腹腔内囊性病变。AOT 模仿其他病理，如肠重复囊肿或肠系膜囊肿 (n = 7)、复杂卵巢囊肿 (n = 3)、成熟囊性畸胎瘤 (n = 3)、单纯性肾囊肿 (n = 1) 和异位肾 (n = 1) 在 15 名 (53.6%) 患者中进行产后超声检查。26 名 (92.8%) 患者进行了择期腹腔镜手术。其他 2 名患者因急性症状需要紧急开腹手术。17 名 (60.7%) 患者的卵巢自动切除。组织病理学检查显示所有标本均有坏死和营养不良性钙化。2 例患者出现肿瘤（浆液性囊腺瘤和性腺母细胞瘤）。早期随访期间未发生并发症（平均：73.9 ± 46.8 个月）。

结论

在产前期间可以很容易地检测到 AOT。肿瘤累及 AOT 很少见，但可能。虽然 AOT 可能与其他囊性病变相似，但在女婴存在可触及的腹内肿块和复杂的囊性病变时，它应该是首先考虑的诊断之一。它可以使用微创技术进行有效和安全的管理。