Cystic Hygroma

History:
The following image set is taken from a 12 weeks pregnancy. 

Findings:
Symmetrical cyst- like anomalies behind the head extending below towards the chest.
(click on the images for full size)

Note:
Your comments are welcome.


Dr. Bulent Potur, Turkey

Editorial and Advisory Board Comments:

1) Looks like septate cystic hygroma - bad luck - high risk for aneuploidy and little chance for happy outcome - Art Fougner

2) I agree with Dr. Fougner, and a karyotype to exclude or confirm Turner Syndrome will be helpful. -Mario Libardi

3) I agree, a cystic hygroma... often found with Turner's Syndrome. - Terry J. DuBose

4) I agree classic bilobed cystic hygroma. 50% aneuploidy rate with Downs and Turner's most common. The ones who have normal chromosomes are treatable. There is a Japanese paper on aspirating and sclerosing them and I have used a Wescott multihole shunt to drain them. This should only be considered if there is evidence of superior vena caval syndrome (upper body oedema etc). Otherwise if euploid it is worth being cautious. Some patients can't take the anxiety and will opt for interruption - Ross Welch

5) Do you have long term follow up? Does this prevent the webbed neck? Can you rule out rarer syndromes like multiple pterygian syndrome? - Roger Sanders

6) Dr. Sanders, pterygian syndrome? My handy dandy electronic medical dictionary didn't have that one. My old paper one did, "pterygian colli: A congenital band of fascia extending from the mastoid process of the temporal bone to the clavicle." I've seen a lot of cystic hygromas, but never pterygium... that I know of. Does multiple pterygian syndrome look like septa in the amniotic fluid? That sounds like it might appear sonographically like a cystic hygroma near the neck in cross section. Do you have any digitized images that we could see? If so, please Email them, with any descriptive text you wish, to me and we will post them. - Terry DuBose