Advantage of conservative surgical management of large ovarian neoplasms in adolescents

Ovarian Dermoid Cyst Super-infected with Methicillin-sensitive Staphylococcus Aureus Leading to the Misdiagnosis of Appendicitis in an Adolescent

“…7 Since the risk of ovarian malignancy in an adolescent with an ovarian mass is significant, appropriate preoperative evaluation should consist of ultrasound exam and serum tumor markers, specifically CA-125, bHCG, AFP, and LDH. 3 Any evidence of malignancy should prompt the surgeon to make arrangements for a possible staging procedure.…”

“…Intra-operative gynecology consultation was requested regarding the ovarian mass. Using recently published data on the surgical management of large ovarian neoplasms in adolescents, 3 and the potential adverse risks of spillage of the neoplasm's contents, the decision was made to return at a later time to resect the ovarian mass so that the proper preoperative evaluation (e.g., AFP, LDH, CA-125, Inhibin-A, and hCG levels) and the appropriate procedure (i.e. laparotomy and cystectomy with ovarian preservation) could be performed.…”

“…3 Upon entrance into the peritoneal cavity, there was a foul odor indicative of purulent material. We were concerned that the appendiceal stump might have become infected.…”

“…A cystectomy was performed as previously described. 3 The remainder of the cystectomy was uncomplicated and the patient's abdomen was irrigated with copious amounts of warm normal saline. Since all of the infected tissue (the dermoid) was removed, the remaining ovarian tissue was preserved.…”

Management of Adnexal Masses in Children and Adolescent Populations: Advocating for Ovarian Conservation

“…Historically, surgical management recommendations were for laparotomy with unilateral salpingo-oophorectomy, in an effort to avoid incomplete excision of cancer. [1][2][3] Laparoscopy has since replaced laparotomy as the surgical method of choice, however ovarian conservation procedures are often not considered unless a gynecologist is present. This goal of this article is to address the importance of ovarian conservation in adnexal masses in children and adolescents.…”