title: Ovarian masses in children and adolescents in China: analysis of 203 cases.
abstract: OBJECTIVE
  The true incidence of ovarian tumors in children is unknown. Few studies beyond case reports and case series have been published concerning pediatric ovarian tumors. Herein we review a large number of ovarian tumor cases.
  
  
  METHODS
  The charts of 203 patients who presented with adnexal masses were reviewed.
  
  
  RESULTS
  The patient's ranged in age from 2 to 18 years (mean = 15.6 years), with 30 being premenarchal (14.8%). The incidence of ovarian tumor increases with age, especially in patients older than 14 years. The main complaint was abdominal pain or abdominal distension in 117 patients (57.7%). A high AFP level in a pre-pubic girl with an adnexal mass is indicative of a malignant ovarian tumor. The 214 adnexal masses (11 patients had bilateral cysts) consisted of benign tumorous oophoropathy (107 masses, 50.0%), borderline and malignant tumors (29 masses, 13.6%), and nontumorous oophoropathy (78 masses, 36.5%). Of the 136 neoplasia, germ cell tumors accounted for 71.5%. Surgical intervention was performed in 98.5% of cases. There were statistically decreased blood loss, surgery duration and days of hospitalization with the laparoscopic procedure when compared with open surgery.
  
  
  CONCLUSIONS
  Abdominal pain is the most common complaint in young patients with adnexal masses. AFP is the most useful diagnostic biomarker of ovarian tumors in young females. Laparoscopic resection of ovarian cysts is an alternative operation approach.
authors.affiliation: Department of Obstetric and Gynecologic, West China Second University Hospital, Sichuan University, Chengdu 610041, China ; Laboratory of Cell and Gene Therapy, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu 610041, China ; Laboratory of Genetics, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu 610041, China ; Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Chengdu 610041, China.
authors.forename: Hongqian
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Diagnostic Imaging, Affiliated Hospital of Zunyi Medical Collage, 201 Dalian Road, Zunyi, Guizhou 563003, China.
authors.forename: Xiangao
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Obstetric and Gynecologic, West China Second University Hospital, Sichuan University, Chengdu 610041, China ; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17177, Sweden.
authors.forename: Donghao
authors.initials: D
authors.lastname: Lu
authors.affiliation: Department of Obstetric and Gynecologic, West China Second University Hospital, Sichuan University, Chengdu 610041, China ; Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Chengdu 610041, China.
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Obstetric and Gynecologic, West China Second University Hospital, Sichuan University, Chengdu 610041, China ; Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Chengdu 610041, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Shi
keywords: Epithelial tumor; Germ cell; Laparoscope; Ovarian mass; Pediatric