PSEUDOCYSTS OF THE UMBILICAL CORD  

A pseudocyst is a cavity that forms from liquefaction or mucoid degeneration of Wharton's jelly. It has no epithelial lining and its etiology is unknown. Large masses of mucus in the umbilical cord are usually associated with hemangiomas of the umbilical cord, also called angiomyxomas. The large pseudocysts are probably fluid collections produced by this tumor. The fluid cannot escape through the thick epithelium of the umbilical cord and appears as a large cystic mass (1).

Bergman 1962 (2); 2 cases - one stillborn and one alive and normal.
Iaccarino 1986 (3); 7cm cyst compressing the umbilical vessels and IUGR. The pregnancy was terminated.
 

UMBILICAL CORD CYSTS AND ANEUPLOIDY

 

Link to Umbilical Cord Pseudocysts and Aneuploidy

 

 

ULTRASOUND


 

 

Trisomy 18:

        Multiple umbilical cord pseudocysts.

        Two vessel cord

 

 

Umbilical cord pseudocyst at 13 weeks of gestation

 

DIFFERENTIAL DIAGNOSIS

True and pseudocysts of the cord have similar appearances; true cysts are usually associated with anomalies of the umbilicus and / or bladder such as omphalocele or patent urachus.
 

MANAGEMENT

 

 

REFERENCES

  1. Harp J, Rouse GA, De Lange M. Sonographic prenatal diagnosis of allantoic cyst. JDMS 1992;8:28-32.
  2. Bergman P, Lundin P, Malmstrom T. Mucoid degeneration of Wharton's jelly: An umbilical cord anomaly threatening fetal life. Acta Obstet Gynecol Scand 1961;40:372.
  3. Iaccarino M, Baldi F, Persico O et.al. Ultrasonographic and pathologic study of mucoid degeneration of the umbilical cord. J Clin Ultrasound 1986;15:127.
  4. Heifetz SA, Rueda-Pedraza ME. Hemangiomas of the umbilical cord. Pediatr Pathol 1983;1:385-398.
  5. Yavner DL, Redline RW. Angiomyxoma of the umbilical cord with massive cystic degeneration of Wharton's jelly. Arch Pathol Lab Med 1989;113:935-937.
  6. Sepulveda W, Gutierrez J, Sanchez J et.al. Pseudocysts of the umbilical cord: Prenatal sonographic appearance and clinical significance. Obstetrics and Gynecology 1999;93:378-381.
  7. Jaunianx E, Campbell S, Vyes S. The use of color doppler imaging for prenatal diagnosis of umbilical cord anomalies: report of three cases. Am J Obstet Gynecol 1989;161:1195-1197.
  8. Benacerraf BR, Miller Wa, Frigoletto FD. Sonographic detection of fetuses with trisomy 13 and 18: accuracy and limitations. Am J Obstet Gynecol 1988;158:404-409.
  9. Benacerraf BR. Prenatal sonography of autosomal trisomies. Ultrasound Obstet Gynecol 1991;1:66-75.
  10. Nyberg DA, Kramer D, Resta RG et.al. prenatal sonographic findings of trisomy 18: a review of 47 cases. J Ultrasound Med 1993;12:103-113.
  11. Sepulveda W, Pryde PG, Greb AE et.al. Prenatal diagnosis of umbilical cord pseudocyst. Ultrasound Obstet Gynecol 1994;4:147-150.