A wandering intraperitoneal mass in a child

A primigravid 29-year-old woman presented for an antenatal ultrasound scan at 33 weeks gestation to evaluate fetal wellbeing. Prenatal sonography showed the fetus has a cystic lesion in the left lower quadrant of the fetus, suggesting a left ovarian cyst. The pregnancy continued uneventfully, the baby was born at 37 weeks. After birth, the child did not have any discomfort, and a regular ultrasound review indicated abdominal mass. When the child was 1 year old, the parents came to our hospital for surgical treatment. We did a pretty thorough preoperative examination. However, it was surprising that ultrasound in our hospital suggested cystic mass in the right lower abdomen, while CT suggested occupying space in the left lower abdomen. This confuses our choice of treatment options. In the end, we chose laparoscopic exploration. In the right lower abdomen, we Peng-yu Chen1 ; Jing Lao1 ; Xiao-peng Ma2 ; Bin Wang2 ; Jian-yao Wang2 * 1 Shenzhen Children's Hospital of China Medical University, Shenzhen 518026, Guangdong Province, China. 2 Department of General Surgery, Shenzhen Children's Hospital, Shenzhen 518026, Guangdong Province, China. see a tawny cystic mass completely free in the abdominal cavity, while the right ovary and part of the right fallopian tubes are completely absent. Gross pathologic examination of the mass showed a 3.5 X 2.5 X 1.8 cm white-gray cyst containing brown fluid. On microscopy, the mass was consistent with a hemorrhagic cyst, ovarian tissue with infarction, and calcification. It was considered to be caused by torsion of the ovary. The patient recovered well after surgery, and no abnormalities were observed during a follow-up of five months. Consideration of a rare diagnosis such as ovarian autoamputation is important when patients present with a wandering intraperitoneal mass [1,2]. For free masses in the abdominal cavity, laparoscopy is recommended when the diagnosis is not clear [3].