Adnexal masses in children, adolescents and women of reproductive age in the Netherlands: A nationwide population-based cohort study

Hermans, Ayke J.; Kluivers, Kirsten B.; Janssen, Laura M.; Siebers, Albert G.; Wijnen, Marc H. W. A.; Bulten, Johan; Massuger, Leon F.A.G.; Coppus, S.F.P.J.

doi:10.1016/j.ygyno.2016.07.096

Cited by 44 publications

(40 citation statements)

References 14 publications

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“…However, a substantial subset occurs in reproductive age women, with the incidence rising with age (125). Majority of ovarian malignancies in young women are germ cell tumors and epithelial borderline tumors, with invasive epithelial ovarian cancers and sex-cord stromal tumors being less common (126, 127). …”

Section: Part Vi: Fertility-sparing Management Of Ovarian Tumorsmentioning

confidence: 99%

Fertility-sparing for young patients with gynecologic cancer: How MRI can guide patient selection prior to conservative management

et al. 2017

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Historically, cancer treatment has emphasized measures for the “cure” regardless of the long-term consequences. Advances in cancer detection and treatment have resulted in improved outcomes bringing to the fore various quality of life considerations including future fertility. For many young cancer patients, fertility preservation is now an integral component of clinical decision-making and treatment design. Optimal fertility-sparing options for young patients with gynecologic cancer are influenced by patient age, primary cancer, treatment regimens, and patient preferences. Possible approaches include embryo or oocyte cryopreservation, ovarian transposition, conservative surgery, and conservative medical treatment to delay radical surgery. These may be used alone or in combination to maximize fertility preservation. Awareness of the various fertility-sparing options, eligibility criteria, and the central role of Magnetic Resonance Imaging (MRI) in the proper selection of patients will enable radiologists to produce complete clinically relevant imaging reports and serve as effective consultants to referring clinicians. Knowledge of the potential imaging pitfalls is essential to avoid misinterpretation and guide appropriate management.

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Section: Part Vi: Fertility-sparing Management Of Ovarian Tumorsmentioning

confidence: 99%

Fertility-sparing for young patients with gynecologic cancer: How MRI can guide patient selection prior to conservative management

et al. 2017

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“…Despite this low incidence, ovarian tumours constitute the most common gynaecological malignancy in children and adolescents. Paediatric ovarian masses encompass a variety of benign and malignant tumours, including rare types such as sex cordstromal tumours [4][5][6]. Both this heterogeneity and the importance of fertility preservation in this age group make the diagnostic assessment of these masses challenging.…”

Section: Introductionmentioning

confidence: 99%

“…While malignant ovarian neoplasms may need a more aggressive surgical approach, benign masses can either be safely monitored or undergo simple resection allowing for a fertilityand ovary-sparing approach [7]. Being able to discriminate between benign and malignant masses of the ovary is therefore of considerable clinical importance in the initial surgical management [4,8]. Ultrasound is the first imaging modality in the diagnostic assessment of ovarian masses at any age.…”

Section: Introductionmentioning

confidence: 99%

MR imaging in discriminating between benign and malignant paediatric ovarian masses: a systematic review

et al. 2019

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Objectives The use of magnetic resonance (MR) imaging in differentiation between benign and malignant adnexal masses in children and adolescents might be of great value in the diagnostic workup of sonographically indeterminate masses, since preserving fertility is of particular importance in this population. This systematic review evaluates the diagnostic value of MR imaging in children with an ovarian mass. Methods The review was made according to the PRISMA Statement. PubMed and EMBASE were systematically searched for studies on the use of MR imaging in differential diagnosis of ovarian masses in both adult women and children from 2008 to 2018.Results Sixteen paediatric and 18 adult studies were included. In the included studies, MR imaging has shown good diagnostic performance in differentiating between benign and malignant ovarian masses. MR imaging techniques including diffusionweighted imaging (DWI) and dynamic contrast-enhanced (DCE) imaging seem to further improve the diagnostic performance. Conclusion The addition of DWI with apparent diffusion coefficient (ADC) values measured in enhancing components of solid lesions and DCE imaging may further increase the good diagnostic performance of MR imaging in the pre-operative differentiation between benign and malignant ovarian masses by increasing specificity. Prospective age-specific studies are needed to confirm the high diagnostic performance of MR imaging in children and adolescents with a sonographically indeterminate ovarian mass. Key Points • MR imaging, based on several morphological features, is of good diagnostic performance in differentiating between benign and malignant ovarian masses. Sensitivity and specificity varied between 84.8 to 100% and 20.0 to 98.4%, respectively. • MR imaging techniques like diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) imaging seem to improve the diagnostic performance. • Specific studies in children and adolescents with ovarian masses are required to confirm the suggested increased diagnostic performance of DWI and DCE in this population.

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“…3 The incidence of ovarian cysts in girls <1 years of age has been estimated to be 5.70/100 000. 4 The total incidence of ovarian cysts in this age-group is probably higher because small clinically insignificant cysts are likely to remain undiagnosed. 5 Benign and malignant ovarian neoplasms are extremely rare in neonates but their incidence increases with age.…”

mentioning

confidence: 99%

“…However, there are little data on the population-based incidence of ovarian neoplasms in children. 4,6 Previous studies have suggested that about half of the ovarian masses in children are neoplastic. 7,8 In a previous study we found that overall incidence of ovarian neoplasms in 0-15-year-old girls was 2.2/100 000 and the median age at presentation was 13 years.…”

mentioning

confidence: 99%

Surgically treated ovarian lesions in preadolescent girls

Ripatti

Taskinen

Koivusalo

et al. 2019

Acta Obstet Gynecol Scand

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Introduction: The purpose of this study was to investigate the epidemiology and characteristics of surgically treated ovarian lesions in preadolescent girls. Material and Methods: This was a retrospective cohort study including all 0-11-year-old girls operated at a single center from 1999 to 2016 for ovarian cysts, neoplasms, or torsions. Patient charts were reviewed for symptoms, preoperative radiological imaging, operative details, and histopathology. Results: We identified 78 girls resulting in a population-based incidence of 4.2/100 000. Infants (n= 44) presented with benign cysts (42/44, 95%, one bilateral), a benign neoplasm (1/44, 2%), and a torsion without other pathology (1/44, 2%). Torsion was found in 25/29 (86%) ovaries with complex and in 3/15 (21%) ovaries with simple cysts in preoperative imaging (p<0.001). Most infants were asymptomatic. Lesions in 1-11-year-old girls (n=34) included benign neoplasms (n=21/34, 62%), malignant neoplasms (n=5/34, 15%), a cyst with torsion (n=1/34, 3%), and torsions without other pathology (n=7/34, 21%). Torsion was more common in benign (17/21, 81%) than in malignant neoplasms (1/5, 20%) (p<0.020). Ovarian diameter did not differ between ovaries with or without torsion (p=0.238), or between benign and malignant neoplasms (p=0.293). The duration of symptoms in lesions with or without torsion was similar. Conclusions: The majority of surgically treated ovarian lesions in preadolescent are benign lesions with torsion. Surgery should be ovary preserving and performed without delay.

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Adnexal masses in children, adolescents and women of reproductive age in the Netherlands: A nationwide population-based cohort study

Cited by 44 publications

References 14 publications

Fertility-sparing for young patients with gynecologic cancer: How MRI can guide patient selection prior to conservative management

Fertility-sparing for young patients with gynecologic cancer: How MRI can guide patient selection prior to conservative management

MR imaging in discriminating between benign and malignant paediatric ovarian masses: a systematic review

Surgically treated ovarian lesions in preadolescent girls

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