The management of mature cystic teratomas in children and adolescents: a retrospective analysis

Abstract

Mature cystic teratomas (MCT) are the most common ovarian tumours seen in children and adolescents. Fifty-two patients <21 years of age had surgical removal of an MCT, 14 of whom were approached laparoscopically. Compared with laparotomy, those patients managed laparoscopically had a significantly shorter hospital stay. Intra-operative tumour spillage occurred in 27 (52%) patients; there were no cases of chemical peritonitis. Available follow-up data on 34 (65%) patients revealed seven pregnancies occurring at a median of 70 months (46-123) postoperatively, including four in patients with intraoperative MCT spill. There were no cases of tumour recurrence during the follow-up period among the 27 (52%) patients managed with ovarian cystectomy. These results demonstrate that some of the conclusions regarding the contemporary management of MCT in adults are applicable to children and adolescents.

A Modified Technique to Reduce Spillage and Operative Time: Laparoscopic Ovarian Dermoid Cyst Enucleation ‘in a Bag’

“…In fact the mean operative time in our experience (64 min) is similar to that reported by Volz et al [10], who used a similar technique, and by Yuen and Rogers [20] (60 min) and Morgante et al [58] (57 min) for open surgery and by Pardi et al [42] for laparoscopy-assisted vaginal removal, but it was lower than what was reported by other authors for laparotomy [18,21,22] or laparoscopy (table 2), [8,9,12,18,19,20,21,22,26,27,29,33,34,36,37,39,40]. Our mean surgical time is also lower than that reported by Ferrari et al [38] or Wang et al [44] for the direct vaginal approach (81 and 78 min, respectively).…”

“…Until recently, dermoid cysts were removed by laparotomy, but nowadays there is really no safe method to avoid spillage, particularly when performing a cystectomy. In fact, dermoid cysts with a thin capsule can often not be enucleated without rupture even by laparotomy [13,16,17,18,19,20,21,22]. Manyonda et al [23] suggested to perform a microlaparotomy to remove dermoid cysts intact.…”

“…In recent years dermoid cysts have increasingly been removed by laparoscopy, and with this technique spillage has been reported in 54% of cases, ranging from 0 to 100% (table 1) [8,9,12,13,16,17,18,19,20,21,22,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41]. In order to reduce the risk of spillage during laparoscopy, some authors propose to remove dermoid cysts via culdotomy through an incision on the posterior vaginal fornix [26,35,42,43,44], but with this technique Teng et al [31] reported 6 cases of spillage from 14 cysts (43%); Reich et al [26] reported 9 cases of spillage in 25 cysts removed vaginally (36%), and in the experience of Nezhat et al [35] spillage occurred in 4 of 9 cysts (44%).…”

Pediatric Laparoscopic Surgery: Four Years Experience in Dhaka Medical College Hospital

“…21,22 Most surgeons agree on the use of laparoscooy when a young female patient complains of vague lower abdominal pain and there are many reports showing that laparoscopy improves diagnosis and provides proper therapeutic option. 23 In our study, among the 5 patients with Adnexal Mass, 3 patients had laparoscopic aspiration followed by excision of the cystic masses.…”

Tumores Anexiales en Niñas Y Adolescentes: Experiencia Del Hospital Clínico De La Universidad Católica De Chile, 1991-2003

“…Se ha descrito que representan a 38% de las neoplasias del ovario y 57% de los tumores germinales en las niñas y adolescentes (12,15,18,19). No se ha descrito degeneración maligna de un teratoma maduro en niñas, aunque existe un 1-2% de ellos que sufre transformación maligna del componente epitelial en las mujeres adultas.…”