Diagnosis and treatment of adnexal masses in children and adolescents.
OBJECTIVE
To evaluate the diagnosis and treatment decisions made in children and adolescents with an adnexal mass.


METHODS
This was a retrospective cohort study among patients younger than age 18 years who were diagnosed with or treated for an adnexal mass at the Radboud University Medical Center, Nijmegen, the Netherlands, between January 1999 and October 2013. Age, signs and symptoms, laboratory results, imaging data, type of surgery including surgeon specialty, and histologic diagnosis were analyzed. Published criteria for characterizing a mass as benign (Papic et al) were applied to the present data set.


RESULTS
One hundred eleven patients were included. The mean age of the patients was 10.2±5.6 years, ranging between 0 and 17 years. Ovarian masses were malignant in 28 patients (25.2%). Surgical therapy was applied in 83.1% of the benign masses and in 100% of the malignant masses. Oophorectomy was performed in 46.4% of the benign masses. The presence of a gynecologist was the only factor that significantly lowered the chance of oophorectomy in benign masses (odds ratio 0.14, 95% confidence interval 0.04-0.47). Papic et al's model had a sensitivity of 40.91% and a specificity of 100%.


CONCLUSIONS
The malignancy rate among patients with adnexal masses in our cohort was one in four patients. Most patients with an adnexal mass were treated surgically, and oophorectomy was performed in almost half of the benign masses. The presence of a gynecologic surgeon protected against oophorectomy in benign cases.


METHODS
II.
Departments of Obstetrics & Gynaecology, Paediatric Surgery, and Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
Ayke J
AJ
Hermans
Kirsten B
KB
Kluivers
Marc H
MH
Wijnen
Johan
J
Bulten
Leon F
LF
Massuger
Sjors F
SF
Coppus
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005833:Genital Neoplasms, Female / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009426:Netherlands / Q000453:epidemiology; D059351:Organ Sparing Treatments / Q000706:statistics & numerical data*; D012189:Retrospective Studies