# Fetal Ovarian Cyst Associated With Disorders of Sex Development: A Case Report

## TL;DR

A fetus with ambiguous genitalia and an ovarian cyst was diagnosed with a rare adrenal disorder after birth.

## Contribution

This case report highlights the association between fetal ovarian cysts and disorders of sex development, specifically CAH.

## Key findings

- A prenatal ovarian cyst was diagnosed in a fetus with ambiguous genitalia.
- Postnatal testing confirmed congenital adrenal hyperplasia (CAH).
- Histopathology revealed a simple follicular cyst after surgical removal.

## Abstract

Ovarian cyst is a frequent abdominal tumor in female fetuses (1/2,600 live births), but its prenatal diagnosis can be challenging in the context of ambiguous genitalia. The most common cause of genital virilization in female fetuses is congenital adrenal hyperplasia (CAH), which results from the overproduction of androgen hormones. These hormones may influence the fetal ovary in a way comparable to polycystic ovarian syndrome (PCOS) in adults, leading to the development of an ovarian cyst that may regress. We present the case of a fetus prenatally diagnosed with a large ovarian cyst and ambiguous genitalia. After birth, a diagnosis of salt-wasting CAH was confirmed. A left salpingo-oophorectomy was performed, and histopathological examination revealed a simple follicular cyst.