Management of ovarian cysts in children and adolescents

Abstract

Key content Most ovarian cysts in children and adolescents are benign. Incidence of large ovarian cysts usually peaks in the first year of life and around menarche; approximately 30% of girls will present with pain. Gynaecologists, paediatric surgeons and general surgeons may manage ovarian cysts. There is a lack of standardised protocols and guidance, so most patients are managed on the basis of an individual clinician’s judgement, preference and experience. Whenever possible, the operation of choice for benign cysts is laparoscopic ovarian cystectomy with ovarian preservation. This review provides an evidence‐based tool for the management of ovarian cysts in children and adolescent girls. Learning objectives To identify ovarian pathology using appropriate imaging in emergency and elective situations. To know that, when possible, a multidisciplinary approach between gynaecologists, radiologists and paediatric surgeons is optimal. To be vigilant for malignant tumours and perform ovarian‐sparing surgery for suspected benign conditions. Ethical issues There are long‐term reproductive consequences of inadvertently removing one or both ovaries. Unnecessary surgery has an effect on patients’ physical and mental wellbeing.

Diagnostic Value of Gynecologic Ultrasonography as A Malignancy Predictor in Children's Ovarian Tumor

“…Malignant ovarian tumors originating from germ cells were rare in children, with the proportion of malignancies only being 3-5%. [8][9][10][11] The study findings supported the notion that the subjects with PA results of malignant ovarian tumors, the radiological findings based on gynecologic ultrasonography scores included: papillary inner wall structure with thickness >3 mm, tumor wall thickness >3 mm, septa thickness >3 mm, morphology solid tumor, internal vascular mass and ascites. Ovarian tumors, including malignant lesions, are large lesions with a maximum diameter of 10 cm or larger, with or without solid components; solid lesions with irregular edges; solid components with papillary projections ≥3 mm originating from the cyst wall or septation; papillary projections ≥4, septal thickness >3 mm, color Doppler with the flow in a solid component, presence of ascites, peritoneal mass or enlarged lymph nodes which are high-risk findings of malignancy.…”

Pediatric Intraabdominal Cysts—A Case Series from a Single Tertiary Center Experience

“…Our findings support ovarian cyst excision as the preferred surgical approach for benign cysts, emphasizing the importance of preserving ovarian function. 13 …”

Re: Management of ovarian cysts in children and adolescents

“…We read with interest the review article by Potdar, Pillai and Oppenheimer 1 on the management of ovarian cysts in children and adolescents. We would like to share our experience of a rare case of autoamputation of an ovarian cyst in a 30‐year‐old nullipara who presented with a 3‐day history of lower abdominal pain.…”