Congenital Tumors
Asim Kurjak in CRC Handbook of Ultrasound in Obstetrics and Gynecology, 2019
Other pathological structures that should be differentiated from cystic hygroma are cervical meningomyelocele, encephalocele, and cystic teratoma of the neck. It is particularly important to distinguish encephalomeningocele and cystic hygroma on the basis of morphological criteria alone. These criteria have been described by Pearce et al.33 and serve as a useful guide for differential diagnosis. Cystic hygroma is usually characterized by the presence of typical multiple septa, contains only fluid, and is located in the posterolateral aspect of the neck. They may sometimes extend over the trunk, back, or extremities. In more than half of our cases, the cystic hygromas were larger than the fetal head. On the contrary, encephalocele is characterized by the presence of the large cyst posteriorly to the head. Although bony defect of the skull may not be seen in some cases, helpful signs which enable correct diagnosis are herniation of the brain tissue in the sac, smaller size of biparietal diameter (BPD), and presence of slight ventriculomegaly.
Nonimmune Hydrops Fetalis
Vincenzo Berghella in Maternal-Fetal Evidence Based Guidelines, 2022
The worst prognosis is expected in cases diagnosed before 24 weeks gestation, cases in which a cystic hygroma is present, or cases with chromosomal abnormalities. Half of cases diagnosed prior to 24 weeks are associated with aneuploidy and have very poor survival. Even in those cases diagnosed prior to 24 weeks without aneuploidy, survival is less than 50% [48]. Counseling should include the option of termination depending on patient preferences. After 24 weeks of gestation, the survival rate in euploid fetuses is nearly 50% when effective treatments are performed. Fetal anemia and fetal arrhythmia are two of the etiologies of NIH associated with >70–90% survival rate, if appropriate treatment is instituted (1). Consideration should also be given to transferring the patient to a tertiary care center for management and delivery where possible.
Test Paper 1
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike in Get Through, 2017
A cystic hygroma is the most common form of lymphangioma and constitutes about 5% of all benign tumours of infancy and childhood. On US scans, most cystic hygromas manifest as a multilocular predominantly cystic mass with septa of variable thickness. The echogenic portions of the lesion correlate with clusters of small, abnormal lymphatic channels. Fluid–fluid levels can be observed with a characteristic echogenic, haemorrhagic component layering in the dependent portion of the lesion. Prenatal US may demonstrate a cystic hygroma in the posterior neck soft tissues. On CT images, cystic hygromas tend to appear as poorly circumscribed, multiloculated, hypoattenuated masses. They typically have characteristic homogeneous fluid attenuation. Usually, the mass is centred in the posterior triangle or in the submandibular space.
Next Generation Sequencing in a Case of Early Onset Hydrops: Closing the Loop on the Diagnostic Odyssey!
Published in Fetal and Pediatric Pathology, 2023
Priya Ranganath, Vineeth VS, Ikromi Rungsung, Ashwin Dalal, Shagun Aggarwal
A third-degree consanguineously married couple was referred in their fifth pregnancy in view of ultrasound done elsewhere showing increased nuchal translucency. Prenatal scan at our center at 13 weeks 4 days showed intrauterine fetal demise with hydrops and cystic hygroma (Figure 1). Cardiac structure assessment by ultrasound was unsuccessful. The fetus was delivered at 14 weeks and underwent autopsy. Previously, the couple had 2 miscarriages with blighted ovums, a spontaneous abortion at 10 weeks and an intra-uterine fetal demise at 23 weeks for which the cause was not evaluated. The autopsy of the present fetus showed subtle facial dysmorphism in form of prominent supraorbital region, mild hypertelorism, and broad short nose with upturned tip of nose, anteverted nares and micro-retrognathia. There was a large cystic hygroma of the neck extending from occiput to lower lumbar region, generalized subcutaneous edema and pleural effusions. Hands showed brachydactyly and 5th finger clinodactyly (Figure 2a–e).
Prenatal diagnosis of cystic hygroma cases in a tertiary centre and retrospective analysis of pregnancy results
Published in Journal of Obstetrics and Gynaecology, 2022
Sureyya Saridas Demir, Erkan Cagliyan, Derya Öztürk, Samican Özmen, Sabahattin Altunyurt, Tufan Çankaya, Elcin Bora
‘Congenital anomalies’ are the group of diseases shown as the second most important cause of perinatal morbidity and mortality after preterm labour (Bennasar et al. 2018; Sak et al. 2019; Pan et al. 2020). Foetal structural anomalies are observed in approximately 3–5% of all pregnancies (Kınay et al. 2016). ‘Cystic hygroma’, also called cystic lymphangioma, is a benign type of congenital malformation which is seen in 75–90% neck (especially in posterior cervical triangle), 20% in axilla, 5% in mediastinum and retroperitoneal region, rarely in thoracic wall, the frequency of which is reported as one in 6000 live births and one in 750 spontaneous abortions (Kadam et al. 2017; Koç 2020; Canbey Goret 2018; Saghir et al. 2020).
Early prenatal diagnosis of 49,XXXXY: two case reports
Published in Journal of Obstetrics and Gynaecology, 2019
Yue-Cheng Lu, Lv-Yin Huang, Yan-Dong Yang, Dong-Zhi Li
A 27-year-old G1P0 woman was given a routine first-trimester scan at 12 weeks of gestation. An isolated cystic hygroma was noticed (Figure 1(C)). Considering the presence of a structural anomaly, a direct diagnostic testing was done with CVS for a chromosomal investigation. A direct analysis and the cell culture showed a homogeneous 49,XXXXY karyotype (Figure 1(D)). The pregnancy was terminated by the request of parents using the vaginal misoprostol. The parents declined the necropsy. The karyotype was normal in both parents.
Related Knowledge Centers
- Birth Defect
- Cyst
- Lymph
- Lymphatic Vessel
- Posterior Triangle of The Neck
- Lymphatic System
- Neck
- Lesion
- Malignancy
- Posterior Triangle of The Neck
- Disfigurement