Umbilical cord cyst
Dr Bruno Di Muzio◈ and Dr Yuranga Weerakkody◉ et al.
Umbilical cord cysts can refer to any cystic lesion associated with the umbilical cord. They can be single (commoner) or multiple.
EPIDEMIOLOGY
They may be seen in ~3% of pregnancies in the first trimester 8.
PATHOLOGY
Umbilical cord cysts can represent either true or false cysts:
-
true cysts: have an epithelial lining
-
false cysts: no epithelial lining (commoner)
ASSOCIATIONS
There are increased associations (especially when there are additional sonographic abnormalities and if there is persistence in the 2nd or 3rd trimester) with certain chromosomal/structural anomalies (reported in the up to 20% in one study 8):
-
aneuploidic conditions such as
RADIOGRAPHIC FEATURES
ANTENATAL ULTRASOUND
They tend to be eccentric in relation to the umbilical cord 7. It can be almost impossible to differentiate a true cyst from a pseudocyst on sonographic grounds. The cyst sizes can be variable ranging from a few millimeters up to 5 cm 11.
TREATMENT AND PROGNOSIS
Most advocate a detailed sonographic assessment to be performed if an umbilical cord cyst is seen. A transient cyst which resolves on subsequent imaging is considered to carry an excellent prognosis.
Concerning factors include:
- multiple cysts 10
- presence of other sonographic abnormalities
- persistence during serial sonographic assessment or persistence into the 2nd or 3rd trimester
DIFFERENTIAL DIAGNOSIS
On ultrasound, consider:
- umbilical arterial aneurysm (UAA): shows flow on color Doppler