[size=20px]A 3 week old girl is referred for a pelvic cyst diagnosed prenatally at 34 weeks of gestation and thought to be of ovarian origin. A postnatal ultrasound done at 2 weeks of age demonstrates a 4 cm cyst close to the bladder, that contains heterogenous debris, septations, and a fluid-fluid level. She is completely well.

 

What is the best course of action at this time?

 

A Schedule laparoscopic cystectomy

 

B Repeat ultrasound in 3 months

 

C Obtain an MRI to further characterize the cyst

 

D Aspirate the fluid within the cyst[/size]

A

B

Correct answer

B Repeat ultrasound in 3 months

 

Given that the vast majority of congenital ovarian cysts will resolve spontaneously and that early surgical intervention does not improve salvage, continued observation would be most appropriate with follow-up ultrasound in 3 months. There is no indication to image further with MRI or aspirate this cyst.