title: Treatment of ovarian lesions in children and adolescents: a retrospective study of 130 cases.
abstract: In this study, we analyze the management of ovarian masses in a total of 130 children surgically treated for 137 ovarian lesions (7 bilateral). The most frequent symptoms were chronic (52.3%) and acute (25.4%) abdominal pain. Histological examination revealed 64 (46.7%) functional lesions, 59 (43.1%) benign neoplasms, 5 (3.7%) malignant ones, and 7 (6.6%) torsed normal ovaries. Ovarian torsion occurred in 36 cases (26.27%). A conservative treatment was performed in 81 (59.1%) girls: 61 (75.3%) treated in nonemergency and 20 (24.7%) in emergency surgery; laparoscopic approach in 35 cases (43.2%); and open surgery in 46 (56.8%). The remaining 56 (40.9%) ovarian masses underwent nonconservative surgery: 40 cases (71.4%) nonemergency and 16 (28.6%) emergency; laparoscopy in 20 patients (35.7%); and open surgery in 36 (64.3%). Fertility preservation should be a goal in the surgical treatment. The management of ovarian torsion should include adnexal detorsion and recovery of the ovarian tissue. In case of benign neoplasms, laparoscopic tumorectomy should be the gold standard; in early stage malignant tumors, fertility-sparing surgery with accurate staging is preferred.
authors.affiliation: 1 Department of Surgical, Medical, Molecular pathology and of the Critical Area, Chair of Pediatric Surgery, University of Pisa, Pisa, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Spinelli
authors.forename: Valentina
authors.initials: V
authors.lastname: Pucci
authors.forename: Silvia
authors.initials: S
authors.lastname: Strambi
authors.forename: Roberto Lo
authors.initials: RL
authors.lastname: Piccolo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Martin
authors.forename: Antonio
authors.initials: A
authors.lastname: Messineo
mesh_terms: D000293:Adolescent; D014408:Biomarkers, Tumor / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D010051:Ovarian Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*; D010052:Ovariectomy; D012189:Retrospective Studies; D014102:Torsion Abnormality / Q000601:surgery; D014463:Ultrasonography
chemical_list: D014408:Biomarkers, Tumor
keywords: fertility-sparing surgery; laparoscopy; ovarian masses; pediatric ovarian cysts; torsion; tumor