Abstract：
BACKGROUND: It remains unclear if fetal repair of myelomeningocele (MM) is associated with a greater risk of developing symptomatic dermal inclusion cysts (ICs) at the neural placode. We report two infants treated with fetal surgery who developed symptomatic IC at less than 1 year of age, and we discuss the current literature on symptomatic IC in children with MM.
METHODS: Two infants underwent fetal MM repair at 24 weeks of gestational age. Case 1 was born at 30 weeks and had two revisions of the MM wound early in life. At 8 months of age, the patient presented with meningismus and imaging findings of an IC, which was resected at the time of presentation. At 3 years of age, this patient was found to have recurrence of the IC after presenting with worsening bladder function and underwent repeat debulking with no recurrence at 6 years of age. Case 2 was born at 32 weeks of gestational age with uncomplicated recovery. At 8 months of age, the patient presented with irritability and fullness at the lumbar repair site. Imaging showed a large IC with restricted diffusion and extension into the subcutaneous tissue; this was resected completely at the time of presentation, see intraoperative photographs. There has been no sign of recurrence at age of 15 months.
CONCLUSIONS: Careful monitoring for IC in infancy in MM patients who have had fetal surgery is recommended.
METHODS: Two infants underwent fetal MM repair at 24 weeks of gestational age. Case 1 was born at 30 weeks and had two revisions of the MM wound early in life. At 8 months of age, the patient presented with meningismus and imaging findings of an IC, which was resected at the time of presentation. At 3 years of age, this patient was found to have recurrence of the IC after presenting with worsening bladder function and underwent repeat debulking with no recurrence at 6 years of age. Case 2 was born at 32 weeks of gestational age with uncomplicated recovery. At 8 months of age, the patient presented with irritability and fullness at the lumbar repair site. Imaging showed a large IC with restricted diffusion and extension into the subcutaneous tissue; this was resected completely at the time of presentation, see intraoperative photographs. There has been no sign of recurrence at age of 15 months.
CONCLUSIONS: Careful monitoring for IC in infancy in MM patients who have had fetal surgery is recommended.
摘要：
背景：目前尚不清楚脊髓膜膨出（MM）的胎儿修复是否与在神经胎盘发生有症状的真皮包涵囊肿（IC）的更大风险相关。我们报告了两名接受胎儿手术治疗的婴儿，他们在不到1岁时出现症状性IC，我们讨论了目前有关MM患儿症状性IC的文献。
方法：两名婴儿在胎龄24周时接受了胎儿MM修复。病例1在30周时出生，并且在生命早期对MM伤口进行了两次修正。在8个月大的时候，患者出现脑膜震颤和IC的影像学发现，在演示时被切除。3岁时,该患者在膀胱功能恶化后发现IC复发,并在6岁时进行了重复减积手术,无复发.病例2出生在胎龄32周，无并发症恢复。在8个月大的时候，患者在腰椎修复部位表现为烦躁和丰满。成像显示大的IC，扩散和向皮下组织的延伸受限；在出现时完全切除，见术中照片。在15个月大时没有复发的迹象。
结论：建议对接受过胎儿手术的MM患者进行婴儿期IC的仔细监测。
方法：两名婴儿在胎龄24周时接受了胎儿MM修复。病例1在30周时出生，并且在生命早期对MM伤口进行了两次修正。在8个月大的时候，患者出现脑膜震颤和IC的影像学发现，在演示时被切除。3岁时,该患者在膀胱功能恶化后发现IC复发,并在6岁时进行了重复减积手术,无复发.病例2出生在胎龄32周，无并发症恢复。在8个月大的时候，患者在腰椎修复部位表现为烦躁和丰满。成像显示大的IC，扩散和向皮下组织的延伸受限；在出现时完全切除，见术中照片。在15个月大时没有复发的迹象。
结论：建议对接受过胎儿手术的MM患者进行婴儿期IC的仔细监测。
