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cysctic sol diagnose in USG scan

My wife is 35 weeks pregnant. According to her recent USG scan "There is evidence of a well defined cystic SOL of size 55x63mm along sacrum in midline [?MENINGOCELE].

To confirm this we get second opinion and similarly USG report says a complex cystic mass is seen in the lumbo sacral region, it measure 63mmx64mm in dimension.

I want to add that her "Level-II USG scan" as well as "triple marker test" were found to be "OK".

Radiologist who did level-II USG said it should be teratoma not meningocele, that would have developed later on as there were no evidence in level-II scan.

I am a layman and don't understand Medical jargon. Could please help me to understand what complication may be for the baby and mother. If delivery would be normal? what worst can happen?
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603463 tn?1220630455
If your wife was my patient, I would recommend a level 3 scan ASAP.  A fetal MRI might also be useful.

A meningomyelocele is a condition caused by failure of the baby's lower spine to develop normally, so that part of the spinal cord and covering membranes are actually exposed. Depending upon the severity of the condition, this can lead to difficulty in movement of the baby's lower limbs.

A triple marker test done in the second trimester of pregnancy should show an elevated AFP level if the baby has a meningomyeloceole. In most cases the level is quite elevated, and not subtle, however, there are false negative tests.

A meningomyelocele would also be present from conception and would not develop later in pregnancy--in other words, it should have been noted on an earlier scan--although there are false negative ultrasound scans too.

It sounds to me as though your doctors are suspecting a teratoma instead of a meningomyeolcele.  A teratoma is a type of tumor which is almost always benign and could potentially be completely surgically removed without complications.

More sophisticated ultrasound or MRI could potentially help to sort out the differential diagnosis before delivery.  One thing I would certainly look at is the presence or absence of movement of the lower limbs.  That should be easy to see regardless of the technology.

In the US, we would almost certainly perform a cesarean section for the delivery.  A planned delivery at term would be ideal so that neonatologists could be present to evaluate the needs of the newborn.

I hope this helps!
Dr B
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