abstract
J Pediatr Adolesc Gynecol
OBJECTIVE:
To analyze the clinical characteristics of ovarian masses in children and adolescents.
MATERIALS AND METHODS:
We
performed a retrospective analysis of patients less than 20 years of
age who were treated at the Obstetrics and Gynecology Hospital of Fudan
(China)
University between March 2003 and January 2012. Medical records were
reviewed for age at operation, including presentation of symptoms and
signs; the levels of tumor markers; imaging examinations; pathologic
findings; the size of masses; treatment; and outcome. Data management
and descriptive analyses were performed using SPSS 16.0.
RESULTS:
A
total of 521 patients were included in this study. Among them, 92 had
non-neoplastic lesions, 382 had benign neoplasms, and 47 had malignant
tumors.
The mean age of the patients was 16.3 ± 2.2 years. The primary
presenting symptoms and signs were abdominal pain (39.5%), menstrual
disorder (31.1%), abdominal swelling (5.4%), and an enlarged abdominal
perimeter (3.3%). Malignant tumors tended to be larger than benign
neoplasms (17.3 ± 8.6 cm vs 9.0 ± 5.7 cm; P = .000). T
here was no age
difference between patients with benign neoplasms (16.3 ± 2.1 y) and
those with malignant tumors (15.7 ± 2.5 y). The operations included
salpingo-oophorectomy, ovarian cystectomy, and oophorectomy. Two
patients with malignant tumors had bilateral salpingo-oophorectomy, and 2
patients who had tumor metastasis underwent a total abdominal
hysterectomy and bilateral salpingo-oophorectomy. Forty-one cases of
malignant tumors received postoperative chemotherapy.
CONCLUSIONS:
Germ cell tumors are the most common malignancy, and mature teratomas are
the most common benign neoplasms in children and adolescents. Abdominal
pain and menstrual disorder are the main reasons for doctor's visit.
Although examination by ultrasound is the preferred auxiliary in the
diagnosis of ovarian pathology, it could not distinguish between benign
and malignant tumors. However, tumor size and tumor markers are helpful
to identify the properties of masses. Surgery is usually better for
treatment, and it is preferable to attempt conservative,
fertility-sparing surgery in adolescents. Postoperative chemotherapy is
necessary for malignant tumors.
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