Doctors Remove Ovarian Cyst in Girl Experiencing Unusual Symptoms   

Doctors Remove Ovarian Cyst in Girl Experiencing Unusual Symptoms

Emma Topp smiling

A week before Christmas in 2021, Emma Topp of Leonardo, New Jersey, was looking forward to celebrating her 15th birthday and her friend’s birthday just two days before her own. The close friends were planning to celebrate their birthdays together in Atlantic City.

But first, she had to get through her gym class, which was proving to be a challenge. She was playing pickleball when she began experiencing pain in her chest and arm, and had a hard time catching her breath.

Despite these weird feelings, Emma finished gym and went to lunch. “I thought it was going to go away,” she says. “You say to yourself what everybody says to themselves: ‘It’s no big deal. I’m freaking out for nothing.’”

But a friend told her she didn’t look right, and the discomfort in her chest persisted. She went to the school nurse’s office, where her heart rate and blood pressure were checked. It was screaming high. The nurse called Emma’s mother, Monique, and told her that Emma needed to go to the hospital.

Discovering the Problem

When Emma arrived at nearby Riverview Medical Center, the medical team evaluated her but couldn’t find anything obvious that was causing her high heart rate and high blood pressure. They transported her via ambulance to the intensive care unit at K. Hovnanian Children's Hospital at Jersey Shore University Medical Center.

Emma Topp at hospital

There, a team of specialists began assessing the situation. Because of Emma’s high blood pressure, the immediate concern was that something was going on with her heart, says Mark Kayton, M.D., division chief of Pediatric Surgery who was part of Emma’s care team, so a chest ultrasound was performed. 

Guillermo Hidalgo, M.D., division chief of Pediatric Nephrology, suggested expanding the imaging to include Emma’s abdomen to examine her kidneys. That’s when the team realized they were dealing with something else entirely: There was a huge mass in her belly.

“The beauty of a children's hospital is that if your child's case takes an unexpected turn, we pivot and bring the appropriate resources to bear,” Dr. Kayton says. “We were able to recognize in the first 24 hours that this wasn't a heart problem at all. In fact, this was coming from her reproductive tract, and when that specialist was needed, they were at her bedside almost immediately.”

Everyone feared the mass was a result of cancer. Once it was removed, it was clear it was a benign ovarian cyst. The football-sized cyst was compressing the structures in Emma’s abdomen, which caused her extremely high hypertension, says Heather Appelbaum, M.D., division chief of Pediatric & Adolescent Gynecology, who removed the 7-pound cyst and an additional cyst the size of a softball that was tucked in behind the larger one.

Ovarian cysts are not uncommon in adolescent patients, Dr. Appelbaum says. What was unusual in Emma’s case was that she did not experience typical symptoms associated with ovarian cysts, such as abdominal pain, and her cyst was not self-resolving. Most ovarian cysts resolve on their own and do not grow to the size of Emma’s.


Moving On

Before surgery to remove the cysts, Emma’s blood pressure needed to be lowered—otherwise, she would be at risk of stroke or heart dysfunction. Dr. Hidalgo fine-tuned her blood pressure using three medications, and surgery was able to be performed successfully.

Because the cysts were fully removed, Emma likely will not experience regrowth, but she will get annual pelvic ultrasounds.

Once she fully recovered, she remained with normal blood pressure, and her doctors cleared her to resume her normal activities, her mom took her and four friends to a water park to celebrate.

“It was super fun,” Emma says. “I was going on the water slides and all that, and having a good time with my friends. I wasn't really thinking of what just happened. I was actually living in the moment.”

Today, Emma is back to doing what she loves: singing, acting and performing in community theater productions.

Emma Topp singing


Next Steps & Resources

As the #1 children's hospital in New Jersey, we are ready to get kids, like Emma, back to being kids. To learn more about our world-class pediatricians, 200+ pediatric specialists, and extensive pediatric programs, visit

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.


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