{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T15:21:43Z","timestamp":1790004103757,"version":"4.0.1"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Intrauterine ovarian torsion with autoamputation (IOTA) in fetuses was uncommon. The vague and non-specific symptomatology of IOTA makes early diagnosis challenging. Potential complications, such as hemorrhagic infarction of the adnexal structures with the subsequent sequelae, may occur. Moreover, therapeutic options, such as conservative or surgical management, for IOTA remain uncertain in the literature. We report three cases of IOTA, two of which were complicated by peritoneal adhesion or spontaneous bacterial peritonitis, confirmed surgically and through laboratory studies. A suspected diagnosis of this uncommon condition was made preoperatively in two cases. Our case reports provided additional information about this rare condition, including the occurrence of complicated bacterial peritonitis, in neonates and infants with IOTA. A review of the literature on imaging diagnosis and management options for IOTA is also included.<\/jats:p>","DOI":"10.3389\/fmed.2025.1509477","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T04:12:14Z","timestamp":1744776734000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Intrauterine ovarian torsion with autoamputation and intra-abdominal wandering mass: a report of three cases and literature review"],"prefix":"10.3389","volume":"12","author":[{"given":"Xinxing","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guojian","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenchao","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xijie","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingliang","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongzhen","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiqun","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinling","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyu","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Geng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"242","DOI":"10.4081\/pmc.2020.242","article-title":"Guidelines of the Italian Society of Video surgery in infancy (SIVI) for the minimally invasive treatment of fetal and neonatal ovarian cysts","volume":"42","author":"Chiarenza","year":"2020","journal-title":"Pediatr Med Chir"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1055\/s-0043-1771211","article-title":"European Paediatric Surgeons' Association. European Paediatric Surgeons' Association consensus statement on the management of neonatal ovarian simple cysts","volume":"34","author":"Saxena","year":"2024","journal-title":"Eur J Pediatr Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"89","DOI":"10.3390\/diagnostics12010089","article-title":"Fetal ovarian cysts: prenatal diagnosis using ultrasound and MRI, management and postnatal outcome-our centers experience","volume":"12","author":"Rotar","year":"2021","journal-title":"Diagnostics"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"S149","DOI":"10.1089\/lap.2008.0128.supp","article-title":"Unusual presentation of antenatal ovarian torsion: free-floating abdominal cysts. Our experience and surgical management","volume":"19","author":"Zampieri","year":"2009","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1467","DOI":"10.1053\/jpsu.2002.35415","article-title":"Minimally invasive management of the prenatally torsioned ovarian cyst","volume":"37","author":"Tseng","year":"2002","journal-title":"J Pediatr Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1002\/uog.26061","article-title":"Using IOTA terminology to evaluate fetal ovarian cysts: analysis of 51 cysts over 10-year period","volume":"61","author":"Romiti","year":"2023","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1649","DOI":"10.1007\/s00383-022-05192-1","article-title":"Laparoscopy is a definitive diagnostic method for auto-amputated ovary in infants","volume":"38","author":"Parlak","year":"2022","journal-title":"Pediatr Surg Int"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1016\/j.jmig.2017.04.006","article-title":"Laparoscopic management of autoamputated ovary in newborns: a report of 2 cases","volume":"24","author":"Ladenhauf","year":"2017","journal-title":"J Minim Invasive Gynecol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"127","DOI":"10.2739\/kurumemedj.MS6934002","article-title":"Risk factors in fetal ovarian cysts for postnatal adverse outcomes","volume":"69","author":"Muto","year":"2024","journal-title":"Kurume Med J"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"185","DOI":"10.2214\/AJR.14.13426","article-title":"Imaging findings of fetal-neonatal ovarian cysts complicated with ovarian torsion and autoamputation","volume":"205","author":"Ozcan","year":"2015","journal-title":"AJR Am J Roentgenol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1007\/s00383-009-2396-9","article-title":"Ovarian autoamputation in a neonate: a case report with literature review","volume":"25","author":"Koike","year":"2009","journal-title":"Pediatr Surg Int"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1007\/s13312-020-1974-8","article-title":"Fetal ovarian cyst managed laparoscopically in the neonatal period","volume":"57","author":"Pal","year":"2020","journal-title":"Indian Pediatr"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1007\/s00383-023-05458-2","article-title":"Ultrasonographic features associated with previous torsion and the impact of surgery in managing neonatal ovarian cysts: a 20-year single-Centre retrospective study","volume":"39","author":"Tyraskis","year":"2023","journal-title":"Pediatr Surg Int"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"501","DOI":"10.2214\/ajr.185.2.01850501","article-title":"Conservative versus surgical treatment for complex neonatal ovarian cysts: outcomes study","volume":"185","author":"Enr\u00edquez","year":"2005","journal-title":"AJR Am J Roentgenol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1016\/j.jpedsurg.2019.01.027","article-title":"Management of ovarian lesions diagnosed during infancy","volume":"54","author":"Rialon","year":"2019","journal-title":"J Pediatr Surg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e1130","DOI":"10.1097\/SLA.0000000000005409","article-title":"And Canadian consortium for research in pediatric surgery (can CORPS). Treatment and outcomes of congenital ovarian cysts a study by the Canadian consortium for research in pediatric surgery (can CORPS)","volume":"277","author":"Safa","year":"2023","journal-title":"Ann Surg"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1002\/pd.5143","article-title":"A systematic review and meta-analysis on fetal ovarian cysts: impact of size, appearance and prenatal aspiration","volume":"37","author":"Tyraskis","year":"2017","journal-title":"Prenat Diagn"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2224","DOI":"10.3390\/diagnostics11122224","article-title":"Diagnosis, management, and therapy of fetal ovarian cysts detected by prenatal ultrasonography: a report of 36 cases and literature review","volume":"11","author":"Hara","year":"2021","journal-title":"Diagnostics"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.ejogrb.2023.01.035","article-title":"Imaging in fetal genital anomalies","volume":"283","author":"L\u00f3pez Soto","year":"2023","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1136\/archdischild-2020-318902","article-title":"Bilateral fetal ovarian autoamputation","volume":"106","author":"Zhou","year":"2021","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1016\/j.jpedsurg.2014.01.040","article-title":"Management of neonatal ovarian cysts and its effect on ovarian preservation","volume":"49","author":"Papic","year":"2014","journal-title":"J Pediatr Surg"},{"key":"ref22","first-page":"329","article-title":"Fetal ovarian cysts: incidence, diagnosis and management","volume":"49","author":"Bryant","year":"2004","journal-title":"J Reprod Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1515\/jpm-2018-0311","article-title":"Fetal abdominal cysts: antenatal course and postnatal outcomes","volume":"47","author":"Sanna","year":"2019","journal-title":"J Perinat Med"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1016\/j.jmig.2007.11.001","article-title":"Two-port laparoscopic management of an autoamputated ovarian cyst in a newborn","volume":"15","author":"Visnjic","year":"2008","journal-title":"J Minim Invasive Gynecol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1148\/radiology.168.3.3043551","article-title":"Neonatal ovarian cysts: sonographic-pathologic correlation","volume":"168","author":"Nussbaum","year":"1988","journal-title":"Radiology"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1433","DOI":"10.1016\/0022-3468(95)90399-2","article-title":"Ovarian torsion: clinical and imaging presentation in children","volume":"30","author":"Meyer","year":"1995","journal-title":"J Pediatr Surg"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1002\/jcu.23044","article-title":"Natural history of fetal ovarian cysts in the prenatal and postnatal periods","volume":"49","author":"Akalin","year":"2021","journal-title":"J Clin Ultrasound"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1002\/jcu.22327","article-title":"Diagnosis of neonatal ovarian torsion: emphasis on prenatal and postnatal sonographic findings","volume":"44","author":"Kim","year":"2016","journal-title":"J Clin Ultrasound"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1530","DOI":"10.21037\/tp-20-440","article-title":"Fetal abdominal tumors and cysts","volume":"10","author":"Cass","year":"2021","journal-title":"Transl Pediatr"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1177\/1742271X20984814","article-title":"Ultrasound and alternative multimodality imaging of intra-abdominal and pelvic cystic masses in the newborn","volume":"29","author":"Lee","year":"2021","journal-title":"Ultrasound"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1046\/j.1469-0705.2002.00725.x","article-title":"Fetal ovarian cysts: prenatal diagnosis, management and postnatal outcome","volume":"20","author":"Heling","year":"2002","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.jpag.2021.08.007","article-title":"The role of surgery in antenatal ovarian torsion: retrospective evaluation of 28 cases and review of the literature","volume":"35","author":"Toker Kurtmen","year":"2022","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1016\/j.jpedsurg.2021.12.043","article-title":"The Canadian consortium for research in pediatric surgery can CORPS. Differentiating congenital ovarian cysts from other abdominal cystic lesions in female infants: a study by the Canadian consortium for research in pediatric surgery (can CORPS)","volume":"57","author":"Safa","year":"2022","journal-title":"J Pediatr Surg"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1258","DOI":"10.1002\/pd.5754","article-title":"Prenatal evaluation and postnatal outcomes of fetal ovarian cysts","volume":"40","author":"Chen","year":"2020","journal-title":"Prenat Diagn"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"e240034","DOI":"10.1148\/rg.240034","article-title":"Neonatal liver imaging: techniques, role of imaging, and indications","volume":"44","author":"Hadian","year":"2024","journal-title":"Radiographics"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.jpag.2013.06.019","article-title":"Non-surgical management of the auto-amputated adnexa in the neonate: a report on two cases","volume":"27","author":"Trotman","year":"2014","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1148\/radiology.164.2.3299483","article-title":"Mesenteric and omental cysts: histologic classification with imaging correlation","volume":"164","author":"Ros","year":"1987","journal-title":"Radiology"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1007\/s00383-021-04935-w","article-title":"Missed opportunities for ovarian salvage in children: an 8-year review of surgically managed ovarian lesions at a tertiary pediatric surgery Centre","volume":"37","author":"Karavadara","year":"2021","journal-title":"Pediatr Surg Int"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1002\/uog.16002","article-title":"Outcome of fetal ovarian cysts diagnosed on prenatal ultrasound examination: systematic review and meta-analysis","volume":"50","author":"Bascietto","year":"2017","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1097\/00003081-198528020-00015","article-title":"Torsion of the adnexa","volume":"28","author":"Nichols","year":"1985","journal-title":"Clin Obstet Gynecol"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1055\/s-0033-1348023","article-title":"Complex fetal ovarian cysts cause problems even after regression","volume":"24","author":"Karaku\u015f","year":"2014","journal-title":"Eur J Pediatr Surg"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.jpag.2012.08.012","article-title":"The auto-amputated adnexa: a review of findings in a pediatric population","volume":"26","author":"Focseneanu","year":"2013","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1002\/uog.18973","article-title":"In-utero aspiration vs. expectant management of anechoic fetal ovarian cysts: open randomized controlled trial","volume":"52","author":"Diguisto","year":"2018","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"105102","DOI":"10.1016\/j.earlhumdev.2020.105102","article-title":"Antenatally detected abdominal cyst: does cyst size and nature determine postnatal symptoms and outcome?","volume":"147","author":"Lewis","year":"2020","journal-title":"Early Hum Dev"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"28","DOI":"10.4274\/jcrpe.v2i1.28","article-title":"Fetal-neonatal ovarian cysts--their monitoring and management: retrospective evaluation of 20 cases and review of the literature","volume":"2","author":"Ak\u0131n","year":"2010","journal-title":"J Clin Res Pediatr Endocrinol"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1053\/j.sempedsurg.2009.02.012","article-title":"Lethal outcome after percutaneous aspiration of a presumed ovarian cyst in a neonate","volume":"18","author":"Puligandla","year":"2009","journal-title":"Semin Pediatr Surg"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1089\/lap.2007.0193","article-title":"Evolution of the surgical management of neonatal ovarian cysts: laparoscopic-assisted transumbilical extracorporeal ovarian cystectomy (LATEC)","volume":"18","author":"Schenkman","year":"2008","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1016\/j.urology.2008.08.497","article-title":"Laparoscopic ovarian cystectomy in children","volume":"73","author":"Shapiro","year":"2009","journal-title":"Urology"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1001\/archpedi.159.6.532","article-title":"Urgency of evaluation and outcome of acute ovarian torsion in pediatric patients","volume":"159","author":"Anders","year":"2005","journal-title":"Arch Pediatr Adolesc Med"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/j.jpag.2013.11.012","article-title":"Neonatal surgery for giant floating abdominal cysts in females: clinical and surgical management","volume":"27","author":"Zampieri","year":"2014","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"514","DOI":"10.9738\/INTSURG-D-14-00005.1","article-title":"Prenatal and postnatal ultrasonographic findings of the torsioned ovarian cyst: a case report and brief literature review","volume":"100","author":"Ogul","year":"2015","journal-title":"Int Surg"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"2004","DOI":"10.1016\/j.jpedsurg.2008.02.060","article-title":"Fetal ovarian cysts management and ovarian prognosis: a report of 82 cases","volume":"43","author":"Galinier","year":"2008","journal-title":"J Pediatr Surg"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1509477\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T04:12:15Z","timestamp":1744776735000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1509477\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,16]]},"references-count":52,"alternative-id":["10.3389\/fmed.2025.1509477"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1509477","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,16]]},"article-number":"1509477"}}