Shane Eakins^1, Patricia Symons^1,2

¹Department of Anatomical Pathology, Liverpool Hospital, Sydney, NSW

²Conjoint Lecturer - Discipline of Medicine, South West Sydney Clinical Campuses, University of New South Wales

Background: Placental surface “cysts” are uncommon lesions visible on the fetal surface. We present four clinical cases; histopathological examination showed benign cysts lined by extravillous trophoblast.

 

Case 1:  25-year-old presented at 35 weeks’ gestation with reduced fetal movements.  At emergency Caesarean section, there were multiple surface cysts seen.

Case 2: 31-year-old delivered a term baby affected by fetal growth restriction. A single surface cyst was seen. 

Case 3: 23-year-old had delivery at term with admission of the infant to the special care unit.  A single surface cyst, avascular villi and widespread thromboses were observed.

Case 4: 26-year-old presented at 38 weeks’ gestation following a precipitate home delivery. Two placental surface cysts, an old villous infarct and perivillous fibrin deposition were seen. 

 

Discussion: The significance and aetiology of surface cysts is debated. Most have an excellent outcome, but some have associated fetal growth restriction, abruption1,2 and a relationship to hypoxia is hypothesised 3. Our series included features of placental hypoxia. Documentation of the size and location of cysts is important, as size >4.5cm and proximity to the cord insertion site are associated with intrauterine growth restriction1,2. When detected radiologically, surface cysts should prompt careful assessment of fetal growth throughout pregnancy.

1.     Brown DL, DiSalvo DN, Frates MC, et al. Placental Surface Cysts Detected on Sonography. J Ultrasound Med. 2002;21:641–646. https://doi.org/10.7863/jum.2002.21.6.641.

2.     Sapna HP, Harsha TN, Sreenivas G. Placental cyst - A rare cause of fetal growth restriction-a case report. J Med Sci Health 2021;7(2):109-111. https://doi.org/10.46347/jmsh.2021.v07i02.018

3.     Jerzy Stanek, Chorionic Disk Extravillous Trophoblasts in Placental Diagnosis, American Journal of Clinical Pathology, Volume 136, Issue 4, October 2011, Pages 540–547. https://doi.org/10.1309/AJCPOZ73MPSPYFEZ

 

I, Shane Eakins, declare that this work was my own idea and I was the main author of this abstract and poster, under the supervision of Dr Patricia Symons, Anatomical Pathologist.