Diagnosis: Neonatal

The following Brief Report was written by residents. A discussion by a member of the residents ’ faculty follows. We invite any resident to submit such articles, together with commentary by a faculty member. Patient Report newborn, full-term baby girl was found to have a ~ 2 cm perianal skin tag and a nontender, mobile pelvic mass. Magnetic resonance imag-ing identified a tethered spinal cord with intraspinal lipoma and a 5 cm left pelvic mass that had a fluid-fluid level (Figure 1). Dif-ferential diagnosis included ovar-ian cyst, gut duplication cyst, mesenteric cyst, and anterior meningocele. At 2 months of age she under-went untethering of her spinal cord and excision of the skin tag. Ultrasound examinations at 4 and 6 months of age showed a persis-tent right lower quadrant cystic mass 7 cm across with an irregular septation and mobile debris. Ex-ploratory laparotomy was per-formed through a transverse pu-bic incision. Upon opening the peritoneum a large, brown, fluid-filled mass on the right fallopian tube was identified (Figure 2). The left ovary and fallopian tube Figure 1. Magnetic resonance image of hemorrhagic ovarian cyst showing fluid-fluid level. appeared normal. Palpation of the liver, spleen, and bowel was unremarkable. As the right ovary could not be identified, the right fallopian tube was ligated and the mass excised. Pathologic evalua-tion revealed a hemorrhagic cyst without evidence of ovarian tissue.