{Reference Type}: Review
{Title}: Symptomatic Dermal Inclusion Cysts in Infants following Fetal Surgery for Myelomeningocele: Report of Two Cases and Review of the Literature.
{Author}: Best BJ;Truong HQ;Foy AB;
{Journal}: Pediatr Neurosurg
{Volume}: 57
{Issue}: 5
{Year}: 2022
{Factor}: 1.165
{DOI}: 10.1159/000526613
{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.