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At the 21-week scan, a left subcutaneous thoracic edema consistent with a cystic multilocular formation was identified without color Doppler blood flow, followed by MRI at 29 weeks showing a multiseptate cystic lesion without mass effect. Amniocentesis with QF-PCR, array-CGH, and TORCH testing was performed at 22 weeks, with subsequent third-trimester imaging documenting stable growth and no invasion. Delivery and ethics statements are included, followed by the diagnostic prompt.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/ultrasound-diagnosis-of-a-subcutaneous-cystic-formation-in-the-fetal-thorax-quiz/417360/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/ultrasound-diagnosis-of-a-subcutaneous-cystic-formation-in-the-fetal-thorax-quiz/417360.png","ImageObject",300,407,{"name":92,"@type":93},"acoobca","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What prenatal imaging findings suggested a fetal subcutaneous cystic lesion?","Question",{"text":113,"@type":114},"At 21 weeks, the scan showed a subcutaneous left thorax edema up to the abdominal region measuring 60×20×15 mm with no blood flow on color Doppler. MRI at 29 weeks confirmed a multiseptate cystic formation in the left thorax wall without blood flow and without mass effect.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What diagnostic workup was performed after counseling?",{"text":118,"@type":114},"After prenatal counseling, amniocentesis was performed at 22 weeks with QF-PCR, array-CGH, and TORCH group testing, and a fetal echocardiogram was also carried out.",{"name":120,"@type":111,"acceptedAnswer":121},"How was delivery planned and what was the outcome?",{"text":122,"@type":114},"Following prenatal counseling, cesarean delivery was planned. An urgent cesarean delivery occurred at 36 weeks and 4 days after preterm premature rupture of membranes, resulting in a 2765 g female infant with APGAR scores of 9/10/10 and an uncomplicated postoperative course.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},417360,1791024513,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":24,"preview_page_count":4},3985747870733,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","| Imaging for Residents – Quiz |\n| --- |\n|  |\n\nUltrasound Diagnosis of a Subcutaneous Cystic Formation in  \nthe Fetal Thorax  \nHugo Barros*, Sara Paiva, Cláudia Pinto, Catarina Ferreira, Elsa Pereira, Adosinda Rosmaninho  \nDepartment of Obstetrics and Gynaecology, ULS do Alto Ave, Guimarães, Portugal  \nSection 1 – Quiz Case Description  \nA 39‑year‑old pregnant woman, primigravida, was referred to our obstetric department in the first trimester of pregnancy for pregnancy surveillance due to her age.  \nFirst‑trimester combined screening reported a low risk for trisomies 13 and 18 and an intermediate risk for trisomy 21 of 1 in 398. After prenatal counseling, the parents refused amniocentesis and opted for cell‑free fetal DNA testing, which showed a low risk for fetal 13, 18, and 21 aneuploidies.  \nThe 21‑week scan showed a live female fetus showing a subcutaneous left thorax edema up to the abdominal region measuring 60 mm × 20 mm × 15 mm without blood flow on color Doppler [Figures 1 and 2] . No other fetal anatomical abnormalities were seen during the scan. The placenta was located on the posterior wall of the uterus, and the amniotic fluid was normal.  \nDue to the finding prenatal counseling was provided, and amniocentesis was performed at 22 weeks. QF‑PCR, array‑CGH, and TORCH group testing were ordered, and a fetal echocardiogram was also performed.  \nA complementary magnetic resonance study was requested at 29 weeks of gestation that showed a cystic formation in the left thorax wall, multiseptate, with no blood flow on color Doppler, measuring 58 mm × 46 mm × 20 mm, without mass effect on the underlying structures [Figure 3] .  \nThe 34‑week scan showed normal fetal growth and amniotic fluid volume and the cystic mass with 60 mm × 50 mm × 30 mm without apparent muscular or bone invasion [Figure 4] .  \nReceived: 23‑02‑2025 Revised: 23‑03‑2025 Accepted: 10‑04‑2025 Available Online: 11‑11‑2025  \n\n| Access this article online |  |\n| --- | --- |\n| Quick Response Code:\u003Cbr>| Website:\u003Cbr>[https://journals.lww.com/jmut](https://journals.lww.com/jmut) |\n|  | DOI:\u003Cbr>10.4103/jmu.JMU‑D‑25‑00030 |\n\nFigure 1: Twenty‑one‑week ultrasound: Sagittal plane of fetal thorax showing a multilocular tumefaction  \nFollowing prenatal counseling, a cesarean delivery was determined as the mode of delivery.  \nThe pregnant woman underwent urgent cesarean delivery at 36 weeks and 4 days after preterm premature rupture of membranes, and a 2765 g female infant was delivered with an APGAR score of 9/10/10 [Figure 5] . The patient’s postoperative course was uncomplicated, and both were discharged on day 3 after delivery. What is the diagnosis?  \nEthics statement  \nThis study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki and its amendments. The authors certify that they have obtained all  \nAddress for correspondence: Dr. Hugo Barros,  \nDepartment of Obstetrics and Gynaecology, ULS do Alto Ave, Guimarães, Portugal.  \nE‑mail: [hugoac.barros@hotmail.com](hugoac.barros@hotmail.com)  \nThis is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License (CC BY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.  \nFor reprints [contact:](contact: WKHLRPMedknow_reprints@wolterskluwer.com)[ WKHLRPMedknow_reprints@wolterskluwer.com](contact: WKHLRPMedknow_reprints@wolterskluwer.com)  \nHow to cite this article: Barros H, Paiva S, Pinto C, Ferreira C, Pereira E, Rosmaninho A. Ultrasound diagnosis of a subcutaneous cystic formation in the fetal thorax. J Med Ultrasound 2025;33:418‑9.  \n 418 © 2025 Journal of Medical Ultrasound | Published by Wolters Kluwer-Medknow   \nBarros, et al.: Ultrasound diagnosis of a subcutaneous cystic formation in the fetal thorax  \nFigure 2: Twenty‑one‑week ultrasound: Transverse plane of fetal ","cbCail7ecKFrnzpi","https://ap.wps.com/l/cbCail7ecKFrnzpi","pdf",1095022,"English","# Section 1 - Quiz Case Description\n## Ethics statement\n## Financial support and sponsorship\n## Conflicts of interest","[{\"question\":\"What prenatal imaging findings suggested a fetal subcutaneous cystic lesion?\",\"answer\":\"At 21 weeks, the scan showed a subcutaneous left thorax edema up to the abdominal region measuring 60×20×15 mm with no blood flow on color Doppler. MRI at 29 weeks confirmed a multiseptate cystic formation in the left thorax wall without blood flow and without mass effect.\"},{\"question\":\"What diagnostic workup was performed after counseling?\",\"answer\":\"After prenatal counseling, amniocentesis was performed at 22 weeks with QF-PCR, array-CGH, and TORCH group testing, and a fetal echocardiogram was also carried out.\"},{\"question\":\"How was delivery planned and what was the outcome?\",\"answer\":\"Following prenatal counseling, cesarean delivery was planned. An urgent cesarean delivery occurred at 36 weeks and 4 days after preterm premature rupture of membranes, resulting in a 2765 g female infant with APGAR scores of 9/10/10 and an uncomplicated postoperative course.\"}]","Ultrasound Diagnosis of a Subcutaneous Cystic Formation in the Fetal Thorax - Quiz | PDF",1790608963]