Management and Outcomes of Ovarian Masses in Children and Adolescents

Abstract

Ovarian masses in the pediatric age group are rare, and malignancies are even less common. We reviewed our large single-center experience to determine the rate of malignancy and discuss management. We retrospectively reviewed the cases of ovarian masses in children in our institution over a 10-year period. Demographic and tumor-specific data were reviewed and analyzed, and a Student's unpaired t test was used where appropriate. A total of 49 children and adolescents with ovarian masses were found. The mean age at presentation was 13.3 years. Eight masses were malignant (16%) with malignant teratoma, dysgerminoma, and germ cell tumors found. These patients responded to chemotherapy, but there were three recurrences noted that responded to further therapy. Seventy-four per cent of the benign tumors were teratomas. The most common presentation was abdominal pain in 27 patients (55%) followed by an abdominal mass. Ultrasound and CT scans were the most common imaging studies with a mean mass size of 14.7 cm. A majority of the patients underwent a laparotomy with 12 per cent having a minimally invasive procedure. Only 37 per cent of the operations were performed by the pediatric surgeons. There were no deaths in this series after a follow up of over 6 years. Most ovarian masses in childhood are benign. Malignant lesions have favorable outcomes with chemotherapy, even with recurrent disease. Consideration for laparoscopic procedures should be given for the benign lesions.