ABSTRACT

Figure 3 (a) Longitudinal scan of the pelvis shows a left adnexal mass with cystic and solid components, (b) Two weeks later the mass had decreased in size and appeared as a simple cyst; the diagnosis of hemorrhagic ovarian cyst was made

Figure 4 (a) Longitudinal scan of the left ovary shows an enlarged edematous ovary with hypoechoic rim. The mass was palpable and was accompanied by laboratory findings of an increased white blood cell count. The child was irritable and in pain, (b) and (c) Doppler studies of the left and right ovaries, respectively, show significant flow in the right ovary as compared with the left. While the latter is not diagnostic it was corroborative of the clinical suspicions. A torsed ovary was removed at surgery

Figure 5 (a) Transverse sonogram of the pelvis shows an enlarged echogenic mass with a slight hypoechoic rim. The mass extended outside the pelvis and was felt in the mid-abdomen, (b) CT scan of the upper pelvis shows a mixed attenuation mass occupying virtually the entire pelvis. This was a 10-year-old girl and the mass upon removal proved to be an ovarian torsion

Figure 6 CT scan of the pelvis for other reasons showed an incidental calcific density behind the left side of the bladder and anterior to the rectum. On explora­ tion the left ovary was not present. The mass was diagnosed as previously calcified torsed and amputated left ovary

Figure 7 (a) and (b) Longitudinal and transverse scans respectively of the pelvis in a 9-month-old girl show a mass behind the uterus. The mass has a focus of increased echogenicity with shadowing. The mass is surrounded by low level echoes as well, (c) Transverse scan shows the mass to be anterior to the rectum and posterior to the bladder, and contain a speck of calcium. An ovarian teratoma tumor was removed at surgery

1. Kurjak A. Ultrasound and the Ovary. Carnforth, UK: Parthenon Publishing, 1994:7,59,33-44

2. Cohen HL, Eisenberg P, Mandel F, et al. Ovarian cysts are common in premenarchal girls. A sonographic study of 101 children 2-12 years old. Am J Roentgenol 1992;159:89-91

3. Cohen HL, Shapiro MA, Mandel FS, et al. Normal ovaries in neonates and infants. A sonographic study of 77 patients 1 day-24 months old. Am J Roentgenol 1993;160:583-6

4. Brandt ML, Luks FI, Filiatrault D, et al. Surgical indications in antenatally diagnosed ovarian cysts./ Pediatr Surg 1991;26:276-82

5. Montag TW, Auletta FW, Gibson M. Neonatal ovarian cyst: prenatal diagnosis and analysis of the cyst fluid. Obstet Gynecol 1983;61:38-41

6. De Sa DJ. Follicular ovarian cysts in stillbirths and neonates. Arch Dis Child 1975;50:45-50

7. Nussbaum AR, Sanders RC, Hartman DS, et al. Neonatal ovarian cysts: sonographic-pathologic correlation. Radiology 1988;168:817-21

8. Garel L, Filiatrault D, Brandt M, et al. Antenatal diagnosis of ovarian cysts: natural history and therapeutic implications. Pediatr Radiol 1991;21: 182-4

9. Nussbaum AR, Sanders RC, Benator RM, et al. Spontaneous resolution of neonatal ovarian cysts. Am J Roentgenol 1987;148:175-6

10. Muller-Leisse C, Bick U, Paullussen K, et al. Ovarian cysts in the fetus and neonate - changes in sonographic pattern in their follow-up and manage­ ment. Pediatr Radiol 1992;22:395-400

11. Jafri SZH, Bree RL, Silver TM, et al. Fetal ovarian cysts: sonographic detection and association with hypothyroidism. Radiology 1984;150:809-12

12. Meizner J, Levy A, Katz M, et al. Fetal ovarian cysts: prenatal ultrasonographic detection and postnatal evaluation and treatment. J Obstet Gynecol 1991; 164:874-8

13. Suita S, Ikeda K, Koyanagi T, et al. Neonatal ovarian cyst diagnosed antenatally: report of two patients./ Clin Ultrasound 1991;12:517-19

14. Bagolan P, Rivosecchi M, Giorlandino C, et al. Prenatal diagnosis and clinical outcome of ovarian cysts. / Pediatr Surg 1992;27:879-81

15. Haller JO, Schneider M, Kassner EG, et al. Sonographic evaluation of mesenteric and omental masses in children. Am J Roentgenol 1978;130:269-74

16. Barr LL, Hayden CK Jr, Stansberry SD, et al. Enteric duplication cysts in children: are their ultrasonographic wall characteristics diagnostic? Pediatr Radiol 1990;20:326

17. Croitoru DP, Aaron LE, Laberge JM, et al. Management of complex ovarian cysts presenting in the first year of life. J Pediatr Surg 1991;26:1366-8

18. Van der Zee DC, van Seumeren IGC, Bax KMA, et al. Laparoscopic approach to surgical management of ovarian cysts in the newborn. / Pediatr Surg 1995;30:42-3

19. Currarino G, Rutledge JC. Ovarian torsion and amputation resulting in partially calcified pedunculated cystic mass. Pediatr Radiol 1989; 19: 395-9

20. Alrabee A, Galliani CA, Giacomantino M, et al. Neonatal ovarian torsion: report of three cases and a review of the literature. Pediatr Pathol 1988;8: 143-9

21. Farrel TP, Boal DK, Teele RL, et al. Acute torsion of normal uterine adnexa in children: sonographic demonstration. Am J Radiol 1982;139:1223-5

22. Graif M, Itzchak Y. Sonographic evaluation of ovarian torsion in childhood and adolescence. Am J Radiol 1988;150:647-9

23. Worthington-Kirsch RL, Raptopolous V, Cohen IT. Sequential bilateral torsion of normal ovaries in a child./ Ultrasound Med 1986;5:663-4

24. Kennedy LA, Pinckney LE, Currarino G, et al. Amputated calcified ovaries in children. Radiology 1981;141:83-6

25. Stark JE , Siegel MJ. Ovarian torsion in prepubertal and postpubertal girls: sonographic findings. Am J Radiol 1994;163:1479-82

26. Breen JL , Maxson WS. Ovarian tumors in children and adolescents. Clin Obstet Gynecol 1977;20:607-22

27. Marshall JR. Ovarian enlargement in the first year of life. Ann Surg 1965;161:372-7

28. Jones HW, Wentz AC, Burnett LS Novak’s Textbook of Gynecology. Baltimore, MD: Williams and Wilkins, 1988:831-47

29. Norris HJ, Jensen RD. Relative frequency of ovarian neoplasms in children and adolescents. Cancer 1972;30:713-18

30. Sisler CL, Siegel MJ. Ovarian teratomas: a comparison of the sonographic appearance in pre­ pubertal and postpubertal girls. Am J Radiol 1989; 154:139-42

31. Siegel MJ, McAlister WH, Shackelford GD. Radiographic findings in ovarian teratomas in children. Am J Radiol 1978;131:613-16

32. Abell MR, Johnson VJ. Ovarian neoplasms in childhood and adolescence 1. Tumors of germ cell origin. Am J Obstet Gynecol 1965;92:1059-81