Prenatal Sonographic Findings of an Isolated Cervical Esophageal Duplication Cyst

Abstract

Received December 3, 2008, from the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (D.M.S., M.D., M.S., M.K., S.Y., O.A.), and Department of Radiology (H.Z.), State University of New York, Downstate Medical Center, Brooklyn, New York USA; and Division of Obstetric and Gynecologic Ultrasound, Department of Obstetrics and Gynecology, New York University Medical Center, New York, New York USA (I.E.T.-T.). Revision requested December 3, 2008. Revised manuscript accepted for publication December 5, 2008. Address correspondence to David M. Sherer, MD, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, 445 Lenox Rd, Box 24, Brooklyn, NY 11203-2098 USA. E-mail: dmsherer@aol.com Abbreviations MR, magnetic resonance n 18 year-old nulliparous patient was followed during pregnancy at the State University of New York Downstate Medical Center. Results of first-trimester nuchal translucency and serum screening and second-trimester serum screening for aneuploidy were negative. Sonography at 22 weeks depicted a singleton male fetus with appropriate-for-gestational-age fetal biometric measurements, a normal amniotic fluid volume, and a single nuchal cord. The fetal anatomy was normal other than the finding of a prominent anechoic structure measuring 2 ×1 cm within the off-center, left aspect of the fetal neck (Figures 1–3). The superficial anterior, posterior, and lateral aspects of the fetal neck area were normal, as was the thyroid gland. Specifically, no masses other than the central cystic lesion were noted. Color Doppler and power Doppler imaging did not detect any flow within the cystic structure. Fetal echocardiographic findings were normal. The patient was offered but declined amniocentesis. She was seen at 4-week intervals, at which the above findings continued to be present throughout gestation. Vaginal delivery was not considered contraindicated, but at 39 weeks’ gestation after arrest of the active phase of labor, the patient underwent a transverse lower segment cesarean delivery. The vigorous male neonate weighed 2810 g and was assigned Apgar scores of 9 and 9 at 1 and 5 minutes, respectively. The umbilical artery pH was 7.32, and the base excess was 0.8. The patient’s postoperative course was uneventful other than endometritis, for which she received intravenous antibiotics. Physical examination of the neonate disclosed no dysmorphic features or abnormal findings. A normal 46,XY karyotype was shown. The neonate received normal feeds and underwent imaging assessment of the cervical lesion. Neonatal sonography depicted a cystic structure at the lower aspect of the neck measuring approximately 1 cm in diameter. No evidence was seen of fluid within the