Noninflammatory ovarian masses in girls and young women

Abstract

The most frequent cause of an ovarian mass requiring surgery in a girl or young woman under 21 years of age is an ovarian cyst, which justifies consideration of a laparoscopic approach. Patient age rather than time of surgery predicted operative approach and surgeon type. Caution should be exercised in patients over age 12 months with a complex mass on ultrasound and clinical evidence of hormonal activity, as these masses are usually malignant.

Advantage of conservative surgical management of large ovarian neoplasms in adolescents

“…When the clinical suspicion for ovarian malignancy remains low, most authorities recommend ovary-conserving surgery (2)(3)(4)(5). Our data demonstrate that the affected ovary resumes a normal size and volume postoperatively, suggesting that the attenuated ovarian cortex naturally resorbs.…”

“…Historically, an oophorectomy has been advocated out of a fear of malignancy. Recent studies, however, report that the incidence of malignancy among adolescents undergoing surgical management of persistent ovarian neoplasms ranges between 4% and 9% (2)(3)(4)(5)(6). In accordance with the Children's Oncology Group, standard surgical staging should be performed when concern for malignancy is high (7).…”

“…In contrast, the surgical management of benign appearing large ovarian neoplasms within this population remains poorly defined. With the advent of serum tumor markers and advancements in radiographic imaging, a more conservative approach has been advocated to maximize the future reproductive potential of these patients (2)(3)(4)(5). To date, there are few studies characterizing the postoperative ovarian size and volume after ovarian cystectomy.…”

Laparoscopic management of adnexal masses in adolescent females: a multidisciplinary approach

“…Even within the adolescent age group, the pathology varies depending on the patient's age. In a series of 140 patients, it was found that ovarian malignancy was more common in girls under 15, with ovarian cysts and benign tumours more likely in older patients [3]. This finding was confirmed in a larger series from the Mayo Clinic [4].…”

Atypical Meigs’ syndrome in a neonate with ovarian torsion associated with an ovarian dermoid cyst

“…Benign ovarian neoplasms rarely present in neonates, although they account for 30-40% of ovarian lesions in children and benign cysts account for 60% [2,3]. Benign follicular cysts develop from hormonal stimulation of the fetal ovary by maternal, placental, and fetal follicle stimulating hormones.…”