Umbilical cord cyst
Umbilical cord cyst can refer to any cystic lesion associated with the umbilical cord. They can be single (commoner) or multiple.
They may be seen in ~3% of pregnancies in the first trimester 8.
Umbilical cord cysts can represent either true or false cysts
- true cysts: have an epithelial lining
- false cysts: no epithelial lining (commoner)
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):
They generally 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
On ultrasound consider
- umbilical arterial aneurysm (UAA): shows flow on colour Doppler
- 1. Sepulveda W, Leible S, Ulloa A et-al. Clinical significance of first trimester umbilical cord cysts. J Ultrasound Med. 1999;18 (2): 95-9. J Ultrasound Med (abstract) - Pubmed citation
- 2. Yonemoto H, Itoh S, Nakamura Y et-al. Umbilical cord cyst detected in the first trimester by two- and three-dimensional sonography. J Clin Ultrasound. 34 (3): 150-2. doi:10.1002/jcu.20199 - Pubmed citation
- 3. Smith GN, Walker M, Johnston S et-al. The sonographic finding of persistent umbilical cord cystic masses is associated with lethal aneuploidy and/or congenital anomalies. Prenat. Diagn. 1996;16 (12): 1141-7. doi:10.1002/(SICI)1097-0223(199612)16:12<1141::AID-PD2>3.0.CO;2-4 - Pubmed citation
- 4. Sepulveda W, Gutierrez J, Sanchez J et-al. Pseudocyst of the umbilical cord: prenatal sonographic appearance and clinical significance. Obstet Gynecol. 1999;93 (3): 377-81. - Pubmed citation
- 5. Ramirez P, Haberman S, Baxi L. Significance of prenatal diagnosis of umbilical cord cyst in a fetus with trisomy 18. Am. J. Obstet. Gynecol. 1995;173 (3 Pt 1): 955-7. Am. J. Obstet. Gynecol. (link) - Pubmed citation
- 6. Zangen R, Boldes R, Yaffe H et-al. Umbilical cord cysts in the second and third trimesters: significance and prenatal approach. Ultrasound Obstet Gynecol. 2010;36 (3): 296-301. doi:10.1002/uog.7576 - Pubmed citation
- 7. Skibo LK, Lyons EA, Levi CS. First-trimester umbilical cord cysts. Radiology. 1992;182 (3): 719-22. Radiology (abstract) - Pubmed citation
- 8. Ross JA, Jurkovic D, Zosmer N et-al. Umbilical cord cysts in early pregnancy. Obstet Gynecol. 1997;89 (3): 442-5. doi:10.1016/S0029-7844(96)00526-1 - Pubmed citation
- 9. Amano Y, Hayashi T, Takahama K et-al. MR imaging of umbilical cord urachal (allantoic) cyst in utero. AJR Am J Roentgenol. 2003;180 (4): 1181-2. AJR Am J Roentgenol (full text) - Pubmed citation
- 10. Ghezzi F, Raio L, Di naro E et-al. Single and multiple umbilical cord cysts in early gestation: two different entities. Ultrasound Obstet Gynecol. 2003;21 (3): 215-9. doi:10.1002/uog.68 - Pubmed citation
- 11. Entezami M, Albig M, Knoll U et-al. Ultrasound Diagnosis of Fetal Anomalies. Thieme. (2003) ISBN:1588902129. Read it at Google Books - Find it at Amazon