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2008-06-30-11 Answer to the case of the week #227 © Shah www.TheFetus.net


Answer to the case of the week #227

September 11, 2008 - September 25, 2008

Jayprakash Shah, MD.

Rajni hospital, fetal medicine center, Ahmedabad Hon. Sonologist & fetal Medicine expert, V S Gen. Hospital & K.M. School of Post graduate medicine, Ahmedabad.

Case report

A 21-year-old primigravida was referred for level III ultrasound scan at 21 week of her pregnancy to rule out a fetal encephalocele. Fetal biometry was normal and a cystic structure was visible at the back of the fetal neck (Image 1). Cervical spine and calvarium were intact which ruled out the encephalocele. The lesion superficial involving only the skin and that is why our final diagnosis was epidermal scalp cyst. Cranially next to the cyst a loop of the umbilical cord was running around the fetal neck. The findings were confirmed postnatally. The baby underwent surgery and is doing well. Unfortunately no postnatal images were taken.

Images 1, 2: The image 1 shows sagittal scan of the fetal nuchal region with a cystic structure at the back of the neck representing epidermal cyst. The image 2 shows transverse color Doppler scan just above the cystic structure described in the image one. A loop of the umbilical cord running around the neck can be seen. 

 

Images 3, 4: 3D images showing a round structure of the neck which turned out to be the epidermal cyst.

 

Video 1: The video shows sagittal and transverse views of the fetal nuchal region with the epidermal cyst.

 

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