"Daughter cyst" sign: A sonographic finding of ovarian cyst in neonates, infants, and young children

OBJECTIVE. The purpose of this study was to assess the value of the "daught er cyst" sign, a sonographic finding of neonatal ovarian cysts, in differen tiating ovarian cysts from other cystic masses in neonates, infants, and yo ung children. SUBJECTS AND METHODS. In a prospective study, 23 neonates, infants, and you ng children (age range, 1 day to 36 months) with a lower abdominal cystic m ass underwent sonography. We defined the daughter cyst sign as the presence of a small cyst along the wall of a cystic mass. The diagnosis of ovarian cyst was made when this sign was present. Detailed pathologic correlation w as available in four ovarian cysts. The size, wall thickness, and contents of the cysts were also evaluated. RESULTS. The 23 cystic lesions included ovarian cyst (n = 11), lymphangioma (n = 3), enteric duplication cyst (n = 3), enteric cyst (n = 1), meconium pseudocyst (n = 2), hydrometrocolpos (n = 2), and urachal cyst (n = 1). The daughter cyst sign was seen in nine (82%) of 11 ovarian cysts but in none of the other cystic lesions. Sensitivity, specificity, and positive predict ive value of the daughter cyst sign for differentiating ovarian cysts from other cystic lesions were 82%, 100%, and 100%, respectively. The daughter c yst corresponded to an ovarian follicle on pathologic examination. CONCLUSION. The daughter cyst sign is a specific sonographic finding for an ovarian cyst and may be useful in differentiating uncomplicated ovarian cy sts from other cystic masses in neonates, infants, and young children.