"Daughter cyst" sign: a sonographic finding of ovarian cyst in neonates, infants, and young children

OBJECTIVE: The purpose of this study was to assess the value of the "daughter cyst" sign, a sonographic finding of neonatal ovarian cysts, in differentiating ovarian cysts from other cystic masses in neonates, infants, and young children. SUBJECTS AND METHODS: In a prospective study, 23 neonates, infants, and young children (age range, 1 day to 36 months) with a lower abdominal cystic mass underwent sonography. We defined the daughter cyst sign as the presence of a small cyst along the wall of a cystic mass. The diagnosis of ovarian cyst was made when this sign was present. Detailed pathologic correlation was available in four ovarian cysts. The size, wall thickness, and contents of the cysts were also evaluated. RESULTS: The 23 cystic lesions included ovarian cyst (n = 11), lymphangioma (n = 3), enteric duplication cyst (n = 3), enteric cyst (n = 1), meconium pseudocyst (n = 2), hydrometrocolpos (n = 2), and urachal cyst (n = 1). The daughter cyst sign was seen in nine (82%) of 11 ovarian cysts but in none of the other cystic lesions. Sensitivity, specificity, and positive predictive value of the daughter cyst sign for differentiating ovarian cysts from other cystic lesions were 82%, 100%, and 100%, respectively. The daughter cyst corresponded to an ovarian follicle on pathologic examination. CONCLUSION: The daughter cyst sign is a specific sonographic finding for an ovarian cyst and may be useful in differentiating uncomplicated ovarian cysts from other cystic masses in neonates, infants, and young children.     

"Plain film" diagnosis of ovarian cyst.

Nuclear images frequently include large areas of the patient which are unrelated to the specific organ system under study. The alert interpreter may discover clinically significant information from these portions of the image. This report describes the diagnosis of an ovarian cyst that was suggested by an absence of activity in the pelvis noted on routine rectillnear bone scan.     

Second branchial cleft cyst with "cyst-within-cyst" appearance

A 68-year-old female consulted our hospital, complaining of a large mass on the left side of the neck. Computed tomography and magnetic resonance imaging revealed the characteristic internal architecture of the mass, in which a small cyst was located within a cystic mass, showing a "cyst-within-cyst" appearance. A final diagnosis of second branchial cleft cyst was made pathologically. A "cyst-within-cyst" appearance is not usually seen in a second branchial cleft cyst. This appearance may be attributed to several fine-needle aspiration biopsies for diagnostic purposes.     

MR imaging of a choledochal cyst

The preoperative magnetic resonance (MR) appearance of a choledochal cyst using the saturation recovery-spin echo technique is presented along with the CT and ultrasound images. Although CT suggested the correct diagnosis of choledochal cyst, the "solid" characteristics depicted by sonography led to confusion. The MR image demonstrated a mass, similar to the CT image with both a long T1 and T2, thus substantiating the cystic nature of the mass. Hepatoscintigraphy confirmed the obstructive nature of the lesion.     

Spontaneous regression of a pituitary cyst

We present a pituitary cyst discovered on MRI in an amenorrheic patient that regressed over months. Although the precise etiology of the cyst is unproven, documentation of pituitary cyst regression has not to our knowledge been described previously. Received: 13 February 1998 Accepted: 8 June 1998     

Antenatal diagnosis of a choledocal cyst

Choledocal cyst is a rare anomaly that usually becomes symptomatic during childhood. Forty to sixty percent of choledocal cysts are diagnosed before 10 years old, usually when complications occur. Today, because of advances in sonographic imaging, some cysts can de diagnosed before birth. The major prognostic factor is the development of complications such as hepatic fibrosis. Early treatment, after postnatal ultrasonography assessment, can reduce the incidence of serious complications. The authors report a case of a choledocal cyst diagnosed at 23 weeks gestation.     

Unusual appearance of a cisternal hydatid cyst

We herein describe a case of an isolated multilocular hydatid cyst occurring in the basilar cisterns, with nondependent levels of different signal intensities shown on MR images. Three portions were visualized on T1-weighted images: the hyperintense inferior aspect, the isointense central part, and the superior aspect of lower signal intensity. The inferior portion was hypointense on T2-weighted images. This unusual appearance was caused by layering of hydatid sand and may represent a characteristic feature of hydatid disease.     

MRI of a dermoid cyst containing hair

A fourth ventricular dermoid cyst examined by CT, MRI and angiography is reported. The combination of CT density and MRI signal indicated the presence of hair within the cyst, which was confirmed at surgery.     

Epiphyseal extension of a unicameral bone cyst

 Epiphyseal extension of a unicameral bone cyst is rare. We report a case of a 13-year-old boy with three pathological fractures through a unicameral bone cyst with epiphyseal involvement in the proximal humerus. These lesions initially tends to expand the humeral epiphysis laterally and progress medially. They also commonly cause a slip of the epiphysis in a medial direction. They also have a greater association with growth retardation and lesser degree of recurrence than their metaphyseal counterpart.