Evaluation and Treatment Results of Ovarian Cysts in Childhood and Adolescence: A Multicenter, Retrospective Study of 100 Patients.
OBJECTIVE
To investigate the characteristics of children with ovarian cysts and evaluate treatment strategies.


METHODS
Retrospective study.


METHODS
Eight pediatric endocrinology clinics, Turkey.


METHODS
A total of 100 children and adolescents with ovarian cysts.


METHODS
Patient data collected via retrospective chart review. Patients were stratified according to age into 4 groups (newborns, 1-12 months, 1-8 years, and 8-18 years).


METHODS
Special emphasis was given to torsion and tumor cases, concomitant diseases, treatment modalities, and problems during follow-up.


RESULTS
Most newborns and infants were asymptomatic with the cysts being discovered incidentally; in girls ages 1-8, symptoms were common, including breast budding (47.1%, 16 of 34) and vaginal bleeding (29.4%, 10 of 34). Girls older than 8 years mostly presented with abdominal pain (31.6%, 12 of 38) and menstrual irregularity (21.1%, 8 of 38). Most of our patients were diagnosed with a simple ovarian cyst, but 9 patients were found to have ovarian tumors. Ovarian torsion was detected in 7 patients; 5 with large and 2 with small cysts (<20 mm). Two patients had central precocious puberty (CPP) at presentation and 5 patients developed CPP during follow-up. The surgical intervention rate was high (38%, 38 of 100), but was associated with earlier treatment year, and this association remained significant after adjusting for confounders (P = .035).


CONCLUSIONS
Most girls have simple cysts, which have a favorable prognosis without intervention; however, there might be coexisting pathologies or complications such as tumors, torsion, and CPP; hence these patients should be evaluated accordingly and treated with a multidisciplinary approach.
Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul, Turkey. Electronic address: bkucukemre@yahoo.com.
Banu Kucukemre
BK
Aydin
Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul, Turkey.
Nurcin
N
Saka
Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul, Turkey.
Firdevs
F
Bas
Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul, Turkey.
Yasin
Y
Yilmaz
Marmara University, Medical Faculty, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul, Turkey.
Belma
B
Haliloglu
Marmara University, Medical Faculty, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul, Turkey.
Tulay
T
Guran
Marmara University, Medical Faculty, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul, Turkey.
Serap
S
Turan
Marmara University, Medical Faculty, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul, Turkey.
Abdullah
A
Bereket
Kocaeli University, Medical Faculty, Department of Pediatrics, Pediatric Endocrinology Unit, Kocaeli, Turkey.
Gul
G
Yesiltepe Mutlu
Kocaeli University, Medical Faculty, Department of Pediatrics, Pediatric Endocrinology Unit, Kocaeli, Turkey.
Filiz
F
Cizmecioglu
Kocaeli University, Medical Faculty, Department of Pediatrics, Pediatric Endocrinology Unit, Kocaeli, Turkey.
Sukru
S
Hatun
Trakya University, Medical Faculty, Department of Pediatrics, Pediatric Endocrinology Unit, Edirne, Turkey.
Digdem
D
Bezen
Trakya University, Medical Faculty, Department of Pediatrics, Pediatric Endocrinology Unit, Edirne, Turkey.
Filiz
F
Tutunculer
Derince Training and Research Hospital, Department of Pediatrics, Kocaeli, Turkey.
Nurcan
N
Cebeci
Sakarya University, Faculty of Medicine, Department of Pediatrics, Pediatric Endocrinology Unit, Sakarya, Turkey.
Pinar
P
Isguven
American Hospital, Department of Pediatrics, Istanbul, Turkey.
Nihal
N
Memioglu
Istanbul University, Cerrahpasa Faculty of Medicine, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul, Turkey.
Oya
O
Ercan
Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul, Turkey.
Sukran
S
Poyrazoglu
Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul, Turkey.
Rüveyde
R
Bundak
Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul, Turkey.
Feyza
F
Darendeliler
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010048:Ovarian Cysts / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D010051:Ovarian Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D011629:Puberty, Precocious / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D014421:Turkey
Aromatase inhibitors; Ovarian cyst; Ovarian torsion; Ovarian tumor; Precocious puberty