Management of Left Choroid Plexus Cyst in an 11-Week Term Infant
A left choroid plexus cyst measuring 0.4 x 0.4 x 0.3 cm in an 11-week term infant with normal neurodevelopment is a normal variant of no clinical significance and requires no further evaluation or follow-up. 1, 2
Understanding Choroid Plexus Cysts
- Choroid plexus cysts (CPCs) are small, fluid-filled structures within the choroid of the lateral ventricles of the fetal brain 3
- They may be single or multiple, unilateral or bilateral, and typically measure <1 cm in diameter, as in this case 3
- CPCs are identified in approximately 1-2% of fetuses during second-trimester ultrasound examinations 1
- Nearly all CPCs resolve spontaneously by 28 weeks gestation 3, 1
- CPCs are not considered structural or functional brain abnormalities 1, 3
Clinical Significance
- When isolated (without other abnormalities), CPCs have minimal clinical significance 1
- For infants with normal neurodevelopment, as in this case, there is no indication for follow-up imaging or postnatal evaluation 1, 2
- Studies have shown no differences in neurocognitive ability, motor function, or behavior in children with euploidy born after a prenatal diagnosis of CPCs 1, 4
- The size (0.4 x 0.4 x 0.3 cm), laterality (left-sided), and number of cysts do not impact clinical significance 1, 5
Management Recommendations
- For an infant with an isolated CPC and normal neurodevelopment, no further evaluation is needed 1
- No follow-up imaging is indicated as this finding is a normal variant with no clinical importance 1, 2
- Parents can be reassured that isolated CPCs do not affect neurodevelopment 4, 3
- The original indication for the ultrasound (possible scalp protuberance/questionable ridging) should be evaluated separately, as it is unrelated to the CPC finding 1
Important Considerations
- It's crucial to distinguish between isolated CPCs (as in this case) and CPCs associated with other abnormalities, which would have different implications 1, 3
- Overreaction to isolated CPCs can lead to unnecessary anxiety and additional testing 3
- The finding of a CPC in an infant with normal neurodevelopment should be considered an incidental finding of no clinical significance 1, 3
- The small size of this CPC (0.4 x 0.4 x 0.3 cm) is well within the typical range for these benign findings 3, 5