title: Management and outcomes of ovarian masses in children and adolescents.
abstract: Ovarian masses in the pediatric age group are rare, and malignancies are even less common. We reviewed our large single-center experience to determine the rate of malignancy and discuss management. We retrospectively reviewed the cases of ovarian masses in children in our institution over a 10-year period. Demographic and tumor-specific data were reviewed and analyzed, and a Student's unpaired t test was used where appropriate. A total of 49 children and adolescents with ovarian masses were found. The mean age at presentation was 13.3 years. Eight masses were malignant (16%) with malignant teratoma, dysgerminoma, and germ cell tumors found. These patients responded to chemotherapy, but there were three recurrences noted that responded to further therapy. Seventy-four per cent of the benign tumors were teratomas. The most common presentation was abdominal pain in 27 patients (55%) followed by an abdominal mass. Ultrasound and CT scans were the most common imaging studies with a mean mass size of 14.7 cm. A majority of the patients underwent a laparotomy with 12 per cent having a minimally invasive procedure. Only 37 per cent of the operations were performed by the pediatric surgeons. There were no deaths in this series after a follow up of over 6 years. Most ovarian masses in childhood are benign. Malignant lesions have favorable outcomes with chemotherapy, even with recurrent disease. Consideration for laparoscopic procedures should be given for the benign lesions.
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, University of Mississippi Medical Center, Jackson, Mississippi, USA. islamsa@surgery.ufl.edu
authors.forename: Saleem
authors.initials: S
authors.lastname: Islam
authors.forename: Sani Z
authors.initials: SZ
authors.lastname: Yamout
authors.forename: John R
authors.initials: JR
authors.lastname: Gosche
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D007813:Laparotomy; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D010052:Ovariectomy; D012189:Retrospective Studies; D016896:Treatment Outcome