title: The Relationship between Intraoperative Rupture and Recurrence of Pediatric Ovarian Neoplasms: Preliminary Observations.
abstract: OBJECTIVE
  We investigated whether rupture increased the recurrence rate of pediatric ovarian neoplasms.
  
  
  METHODS
  20-year single-institution retrospective study.
  
  
  METHODS
  Tertiary, free-standing, university children's hospital.
  
  
  METHODS
  All girls with ovarian neoplasms treated during between 1991 and 2011.
  
  
  METHODS
  Tumor recurrence.
  
  
  RESULTS
  Fifty-nine tumors in 53 patients were managed, including 51/59 (86%) benign and 8/59 (14%) malignant. Laparotomy was employed in 44/59 (75%), laparoscopy in 8/59 (14%), and laparoscopy converted to laparotomy in 7/59 (12%). Total and partial oophorectomy (cystectomy) was used for 15/51 (29%) and 36/51 (71%) of benign tumors, respectively. All malignant tumors underwent total oophorectomy. Accidental rupture or intentional tumor puncture occurred in 26/56 cases (46%), 23/51 benign and 3/5 malignant. Rupture was associated with increasing cyst size on univariate and multivariate analyses (p = 0.002 and p = 0.004, respectively). There were 5 recurrences (9%) in 4 patients, including 4 benign (3 mature teratomas, 1 mucinous cystadenoma), and 1 malignant yolk sac tumor. Recurrence occurred in 2/30 (7%) without rupture and 3/26 (12%) with rupture, p = 0.66. Follow-up was available for 50/53 patients (94%), with a median of 23.8 months [range 0.2-189 months]. All recurrences were salvaged by surgery.
  
  
  CONCLUSIONS
  In this limited study, intra-operative rupture did not increase the recurrence rate or worsen the prognosis of pediatric ovarian neoplasms.
authors: Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
authors: Yasmine
authors: Y
authors: Yousef
authors: Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
authors: Valentina
authors: V
authors: Pucci
authors: Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada. Electronic address: Sherif.Emil@McGill.ca.
authors: Sherif
authors: S
authors: Emil
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018291:Cystadenoma, Mucinous / Q000473:pathology / Q000601:surgery; D003884:Dermoid Cyst / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000209:etiology*; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery; D010052:Ovariectomy / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011379:Prognosis; D012189:Retrospective Studies; D012422:Rupture, Spontaneous / Q000150:complications / Q000473:pathology / Q000601:surgery; D013724:Teratoma / Q000473:pathology / Q000601:surgery
keywords: Adolescent; Outcomes; Ovarian tumors; Pediatric; Recurrence; Rupture