4.3 Review

Fetal abdominal tumors and cysts

期刊

TRANSLATIONAL PEDIATRICS
卷 10, 期 5, 页码 1530-1541

出版社

AME PUBL CO
DOI: 10.21037/tp-20-440

关键词

Fetal surgery; sacrococcygeal teratoma; prenatal diagnosis; fetal ovarian cyst; perinatal neuroblastoma

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This article reviews the diagnosis and management of common abdominal neoplasms and cystic lesions in fetuses, discussing prenatal screening with ultrasound and fetal MRI. Accurate prenatal diagnosis is essential for optimal delivery planning and postnatal management recommendations.
This article reviews the contemporary diagnosis and management of the most common abdominal neoplasms and cystic lesions diagnosed in the fetus. Fetal tumors discussed include teratomas (sacrococcygeal, cervical or mediastinal), mesoblastic nephroma, nephroblastoma (Wilms' tumor), neuroblastoma, and hepatoblastoma. Fetal abdominal cystic lesions discussed include ovarian cyst, choledochal cyst, intestinal duplication cyst, mesenteric cyst, simple hepatic cyst, and meconium pseudocyst. We discuss the rare indications for fetal intervention or fetal surgery and other perinatal management, including prenatal interventions and fetal surgery for sacrococcygeal teratoma. The lesions reviewed are detected by widespread use of screening ultrasonography during pregnancy. Work-up for these abnormalities may include fetal M RI which enhances the diagnostic accuracy of abdominal tumors and cystic lesions and can aid in characterization of the lesion in relationship to surrounding anatomic structures. Accurate prenatal diagnosis of such lesions permits recommendations for optimal location and timing of delivery, and inclusion of appropriate caregivers and expertise to facilitate postnatal management. Perinatal management of the fetus with a neoplasm requires consideration of the optimal timing and mode of delivery, and pediatric oncology and surgical specialty care. The majority of tumors diagnosed antenatally have good prognosis with current multimodality treatment.

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