Chocolate-coloured Mass (Differential Diagnosis as before)
7-day-old newborn with an abdominal mass. The excised chocolate-colored mass has a size of 7 to 6 cm and is cystic.
In newborns, too, an increase of the volume of the ovary may lead to torsion. There are mostly benign cysts which lead pre-, peri-, or postnatally to torsion followed by hemorrhage. The degradation of the blood leads to a chocolate-colored mass as in the presented case.
The clinical presentation in these cases is less frequent 'surgical abdomen' than a
palpable and mobile tumor of the lower abdomen. An ultrasound is indicated to differentiate it from another pathology and to decide the further proceeding: In pre- and postnatally diagnosed anechogenic cysts of the size of 5 and more cm, and in all septated cysts, in cysts with multiple echos, and in cysts with solid elements, surgery is indicated due to the danger of torsion, of a former torsion as in the present case, or of a malignoma.
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