Jt. Vanwinter et al., SURGICALLY TREATED ADNEXAL MASSES IN INFANCY, CHILDHOOD, AND ADOLESCENCE, American journal of obstetrics and gynecology, 170(6), 1994, pp. 1780-1789
OBJECTIVE: We retrospectively evaluated the clinical presentation and
histopathologic findings of benign and malignant adnexal masses in inf
ants, children, and adolescents. STUDY DESIGN: Between 1955 and 1992,
486 patients (aged 7 days through 20 years) with adnexal masses were s
urgically evaluated. RESULTS: Of 521 adnexal masses, 92% were benign,
including 335 nonneoplastic and 144 of 186 (77%) neoplastic lesions. T
he frequency of ovarian malignancies correlated inversely with patient
age. Germ cell, stromal, and epithelial malignancies accounted for 40
%, 21%, and 33%, respectively, of the 42 cancers. Nonconcordance betwe
en preoperative and postoperative diagnoses was noted in 94 cases. The
most common preoperative diagnosis necessitating reassignment was acu
te appendicitis. During the last decade of this study, ultrasonography
and computed tomography missed no malignancies. CONCLUSION: Physician
s who care for young girls must be familiar with the differential diag
nosis of adnexal masses to advise conservative management when appropr
iate and surgical intervention when necessary.