Dl. Cass et al., Surgery for ovarian masses in infants, children, and adolescents: 102 consecutive patients treated in a 15-year period, J PED SURG, 36(5), 2001, pp. 693-699
Background/Purpose: Ovarian pathology, although rare in children, must be i
ncluded in the differential diagnosis of all girls who present with abdomin
al pain, an abdominal mass, or precocious puberty.
Methods: To improve clinical appreciation of these lesions, the authors rev
iewed the presentation, evaluation, and outcome of all patients with ovaria
n pathology surgically treated at their institution since 1985.
Results: One hundred two girls (aged 9.8 +/- 5.5 years; range, 2 days to 20
years) underwent 106 separate ovarian operations (43 salpingo-oophorectomi
es, 21 oophorectomies, 33 ovarian cystectomies, and 9 ovarian biopsies). Of
those presenting with acute abdominal pain (n = 59), 25 (42%) had ovarian
torsion (14 associated with a mature teratoma), and only 1 (2%) had a malig
nant tumor. In contrast, of those presenting with an abdominal mass (n = 23
), 6 (26%) had malignancies. There was no age difference between those with
benign disease (9.9 +/- 5.6 years; n = 96) and those with malignant tumors
(8.6 +/- 3.9 years, n = 10). Nine children had 10 operations for presumed
malignant tumors (3 dysgerminomas, 2 immature teratomas with foci of yolk s
ac tumor, 2 juvenile granulosa cell tumors, 1 yolk sac tumor, and 1 Sertoli
-Leydig cell tumor). These patients all had unilateral salpingo-oophorectom
y, 4 had chemotherapy, and all are now disease free at 8.4 +/- 4.1 years fo
llow-up.
Conclusions: Ovarian pathology remains a rare indication for surgery in gir
ls less than 20 years of age. Because most of these lesions are benign, ova
rian-preserving operations should be performed whenever feasible. J Pediatr
Surg 36:693-699. Copyright (C) 2001 by W.B. Saunders Company.